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Medicaid Cuts Would 'Decimate' In-Home Services For Disabled Texans, Advocate Says

Jorge Sanhueza-Lyon
Bob Kafka, an organizer with ADAPT Texas, says proposed cuts to Medicaid under the Senate's health care bill would severely impact people with disabilities.

The Senate’s proposed replacement for the Affordable Care Act has “declared war on people with disabilities of all ages,” a disability rights advocate said Monday after the Congressional Budget Office released a report scoring the legislation.

The bill cuts almost $800 billion from Medicaid over a 10-year period, the CBO found.

Bob Kafka, an organizer with the disability rights group ADAPT Texas, says people with disabilities will suffer. Because Texas never expanded Medicaid, spending caps on the program will greatly hit this population, in addition to children and pregnant women.

Kafka says Texas already does not spend enough on home health services, which are part of the state’s Medicaid program. Community attendants often make about $8 an hour, so it’s hard to find people to do the work.

Kafka, who uses a wheelchair, says he and others like him need help doing basic things every day.

“A person with a disability, like myself, may use a community attendant to get out of bed, help get dressed, toileting, feeding, bathing, basic hygiene-type things, grocery shopping,” he says.

“We have long waiting lists for some of those services,” Kafka says. If cuts to Medicaid go through, "the home care agencies will get even less money.”

Big cuts would certainly be felt.

“You'll see in-home services really being decimated, and people will be forced into more expensive nursing homes,” he says. "We have fought for over a quarter of a century to get and keep people out of institutions."

And that’s just home services. Anne Dunkelberg, an associate director with the Center for Public Policy Priorities, says the spending caps in the Senate bill would strain services across the board.

She says no other public health program – like Medicare or the health programs federal legislators rely on – have spending caps like those the Senate bill proposes.

“If they could come up with a cap that would really work and was fair, that people on Medicaid would accept and all members of Congress would accept, then I might feel OK about imposing it on our poorest and our sickest and our most vulnerable,” Dunkelberg says.

Kafka also points out that if Obamacare is repealed, a program to help keep people out of nursing homes by providing in-home attendants will go away with it. Under the Senate bill, the Community First Choice program, which Texas and seven other states took advantage of, will expire in 2021.

Ashley Lopez covers politics and health care. Got a tip? Email her at Follow her on Twitter @AshLopezRadio.
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