Senate Healthcare Proposal Threatens People with Disabilities and Addictions

NYAPRS Note: Disability advocates are clear: by slashing federal Medicaid payments, removing guaranteed entitlement status to the program and turning it over to what the states are willing to fund and who they’re most willing to help, the health and lives of Americans with disabilities and those with addictions will be directly threatened.

"The American Health Care Act caps and significantly cuts Medicaid which will greatly reduce access to medical care and home and community based services for elderly and disabled Americans who will either die or be forced into institutions," ADAPT organizer Bruce Darling, who took part in the protest, said in a statement.

Capitol Police took 50 protesters into custody after some of them removed themselves from their wheelchairs as part of the "die-in" demonstration, according to a statement from an ADAPT spokesperson. See photos at http://www.businessinsider.com/disabled-people-die-in-protest-mitch-mcconnell-senate-republican-gop-health-care-bill-2017-6 and video at http://time.com/4829103/mitch-mcconnell-protest-senate-health-care-bill/.

Terming the Senate’s Healthcare proposal, the “Unaffordable Care Act,” the New York Times editorial board viewed the bill is “plain and simple, a plan to cut taxes for the wealthy by destroying critical federal programs that help provide health care to tens of millions of people.

If passed in its current form, the Senate bill would greatly weaken Medicaid, the federal-state program that provides insurance to nearly 69 million people, more than any other government or private program. It would do this by gradually but inexorably shifting more of the financial burden of Medicaid to states, in effect, forcing them to cover fewer people and to provide fewer services. Over all, the Senate would reduce federal spending by about $1 trillion over 10 years and use almost that much to cut taxes for rich families and health care companies.

The rollback of Obamacare’s intended expansion of Medicaid would proceed more slowly than under the House’s timetable. But the long-term damage might be worse. That is because the Senate bill would cap federal spending on Medicaid on a per-person basis.

Currently, federal spending varies from year to year based on demand for medical services and the cost of care. Starting in 2025, the cap would be allowed to increase at the rate of inflation in the economy. But the overall inflation rate has typically been much lower than the inflation rate for medical services; in 2016, the overall inflation rate was 1.3 percent, whereas medical costs increased by 3.8 percent. Over time, this would means states will get a lot less money than they do under current law.

The inevitable shrinkage in Medicaid will be particularly devastating to older Americans. Contrary to what many people think, the program does not just benefit the poor. Many middle-class seniors depend on it after they have exhausted their savings. Medicaid pays for two-thirds of the people in nursing homes. The disabled and parents who have children with learning disabilities also rely on Medicaid. The program covers nearly half of all births in the country.

And in recent years, it has played a very important role in dealing with the opioid epidemic, especially in states like Kentucky, Massachusetts, Maryland, Ohio and West Virginia. Medicaid pays between 35 percent and 50 percent of the cost of medication-assisted addiction treatment, according to two professors, one from Harvard and one from New York University.

More: the bill rolls back the federal government’s generous funding for Medicaid expansion, which has been a major source of substance abuse treatment amid the opioid epidemic. The Senate draft earmarks $2 billion for opioid treatment in 2018 — compared to the House's provision of $15 billion over 10 years for mental health, substance abuse and maternity care. The Senate bill does loosen some restrictions on Medicaid funding of long-term treatment for people with substance abuse and mental health issues.