What happened to the idea of preserving Medicaid for those most in need?

The proposed American Health Care Act, specifically the part that imposes per capita caps on Medicaid spending, will have a profoundly negative impact on our most vulnerable citizens, particularly those with intellectual and developmental disabilities. Currently, approximately 40% of Medicaid spending goes to care for people who are disabled, including those with these conditions.

The Act is projected to cut Medicaid by about $116 billion over the next 10 years, forcing states to make up the difference with cuts to medical services, provider reimbursement, or both. This will strain an already lean system leading to serious consequences.

Cuts to Medicaid funding and the imposition of per capita caps would significantly limit, and in some cases even deny, lifesaving medical care for patients who suffer from intellectual and developmental disabilities and similar conditions, such as traumatic brain injury.

This care also includes support for activities of daily living that these patients need to function at a basic level, including nursing care, physical and occupational therapy, speech-language pathology services, medical social services, medications, medical supplies, transportation and dietary counseling and services. Evidence-based studies demonstrate that the medical needs of persons with intellectual and development disabilities are significantly greater than those of the general population, and as a result, their care is more costly.

The American Health Care Act not only impacts funding for services for these vulnerable patients, it produces collateral consequences for those closest to them, their families. It also burdens direct support staff who’s job it is to provide the care they need.   

As the Act moves forward, Congress should weigh carefully the dramatic cuts to Medicaid it includes, which will have devastating effects on those in greatest need.

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