The budget deficit dialogue underway at both state and federal levels seriously threatens the well-being of individuals with disabilities. Various proposals to restructure Medicaid are being floated, but the one that has received the most publicity would end the federal government’s commitment to pay approximately 60 percent of state expenditures for mandated services to specific populations—including people with special needs. Instead, Washington would distribute block grants to the states, with very few strings attached.
Why is this a terrible idea? Given the budget-balancing problems faced by virtually every state, it is likely that, absent federal oversight, important programs for vulnerable populations will be gutted. In my home state of Arizona, budget cuts have already resulted in the discontinuation of coverage for about 250,000 adults without children, as well as the introduction of co-payments and the end of subsidized transportation to medical appointments.
Moreover, it’s simply bad economics to slash Medicaid. Adopting that course would actually cost taxpayers more in the long run. Uninsured individuals will simply turn to emergency rooms. Federal law forbids hospitals to turn away individuals seeking medical treatment, and emergency room care is notoriously expensive—especially in comparison to the preventive measures that Medicaid can cover.
Medicaid is an essential tool in the efforts of millions of people with disabilities to forge lives of dignity and self-direction. But there are powerful interests lobbying to overturn decades of social progress. Concerned citizens should contact their legislators to explain that skillful budget surgery requires a scalpel, not a machete.