View more of the Sun's opinion section
According to Pew Center data, 1 in 4 Americans reports having a disability, so the current fight over the repeal of Affordable Care Act not only impacts millions of Americans, the concern over it is about much, much more than politics.
It’s a matter of life, liberty and independence.
Millions of people with disabilities depend on Medicaid for basic medicine, procedures and assistive devices to keep them alive. That is why the so-called Better Care Reconciliation Act, the legislation drafted by Senate Republicans to “replace” the ACA, could amount to a death sentence for Nevadans with disabilities.
The Congressional Budget Office estimates that the BCRA would cut Medicaid by $772 billion and that 15 million people would lose Medicaid coverage over the next 10 years. The bill would change the Medicaid system to a per capita cap, which would limit the amount of funding states receive each year, leaving individual states to decide whether to restrict the amount of services provided, lower the number of people covered, or some combination of both. Either way, millions of people with disabilities would lose the services that allow us to go to school, work and live in our communities.
Such deep cuts to Medicaid essentially target people with disabilities because the program provides critical services that help us live and participate in our community. Here in Nevada, 13.3 percent of our population lives with a disability. Nationwide, people with disabilities make up about 14 percent of Medicaid participants but account for 40 percent of the cost. And since the poverty rate of working-age people with disabilities in Nevada is 24 percent, disproportionate numbers of them depend on Medicaid because either we cannot obtain or cannot afford private insurance.
Millions of Americans with disabilities depend on Medicaid for personal care services in our own homes, but the BCRA could further limit coverage for home and community-based services. So less funding for Medicaid means that many disabled Americans will either die or be forced into a nursing facility against our will, stripping us of their liberty.
Not only is that cruel and un-American, but it doesn’t make good fiscal sense. You might be surprised to learn that institutionalizing disabled people is actually costlier than simply providing us with the services we need. In 2015, the median annual cost for nursing facility care was $91,250 compared to $45,800 for home and community-based services.
Beyond disabled people, many other vulnerable populations are unnecessarily put at risk. Consider the fact that 18,000 veterans living in Nevada depend on Medicaid for their coverage rather than the Veterans Administration. Or that 64 percent of Nevada births are financed by Medicaid. Most importantly, we must protect those with pre-existing conditions and ensure they can afford meaningful coverage to get the care they need. And the BRCA could threaten the $3.8 million Nevada receives from the Prevention and Public Health Fund, which goes toward efforts like combating diabetes and heart disease.
The ACA should not be repealed without a simultaneous replacement guaranteeing high-quality, comprehensive and affordable coverage for all those who have it now, including 10 million people with disabilities currently on Medicaid nationwide. So far, Sen. Dean Heller, R-Nev., has done an admirable job of resisting the tremendous pressure his party is placing on him to support this very harmful bill. Let’s hope he remains committed and continues to advocate on behalf of Nevadans, particularly those of us with disabilities.
Helena Berger is the president and CEO of the American Association of People with Disabilities, a national disability-rights organization.
Join the Discussion:
Check this out for a full explanation of our conversion to the LiveFyre commenting system and instructions on how to sign up for an account.
Full comments policy