Are people with disabilities to bear the brunt of the debt reduction burden?

Posted on April 13, 2011 by Kirsten Dunham

Debt reduction is something that is on a lot of people’s minds.  Reaching agreement on raising the debt ceiling is going to be as challenging as avoiding a government shut-down.  

So, we know that attention being paid to government spending.  We shouldn’t be surprised if every budget item is looked at through the lens of “What is the tax-payer getting out of spending a dollar on this program?” 

Programs like Medicaid and Medicare are targets for Commissions and Congressmen looking for ways to reduce spending.  A big reason for the price-tag of these programs, however, is the rising health care costs.   One way to save money in these public health care programs is to reduce the costs of the overall health care system.

Congressman Paul Ryan has proposed turning Medicaid into a “block grant” – basically capping federal funding and requiring states to deliver services to eligible individuals using that fixed dollar amount.   If more people were eligible than predicted (remember the recent recession and the still high unemployment rate?) or health care costs rose more rapidly, the state would be responsible for all of the cost not covered by the block grant.  Or, a state that does not want to spend the money would probably cut services or eligibility.  Which do you think is more likely?  Some supporters of block grants say it would give the states more flexibility.  But remember, this idea is being presented as a part of a budget cutting plan and the way to do that is give states less funding than they currently receive. 

What would happen if the federal government capped Medicaid funding and it was not enough to meet Missouri’s needs?  Benefits like personal assistance services and Developmental Disabilities home and community-based services are optional.  If these services were cut, waiting lists would be even greater; people would go without necessary health care and be at risk of nursing home placement.  Missourians with disabilities are already going without.  Under the current funding structure, our low eligibility guidelines force low-income people to spend large out-of-pocket amounts to become Medicaid eligible, they have no dental coverage and our buy-in program for workers with disabilities is extremely limited and prevents many people from returning to work.  Our chances of removing these and other barriers to health care and work for people with disabilities will be even less if federal funding is capped.

Let’s change this debate to include a more balanced approach that does not find two-thirds of the budget savings by cutting programs that help people with limited incomes, including people with disabilities.