President Trump is taking every opportunity to fool Americans about what the health care repeal bills would do. On Wednesday, he tweeted that Medicaid spending "actually goes up" under the Senate bill. On Sunday, White House counselor Kellyanne Conway flatly denied that the repeal bill cuts Medicaid. Both claims are undeniably misleading. The Senate’s the Better Care Reconciliation Act (BCRA) would not just cut Medicaid by 35 percent over the next 20 years, it would end Medicaid as we know it.
It would do this by capping the amount of money the federal government contributes to the states to cover Medicaid, ending the government’s longstanding open-ended commitment to provide funding for enrollees. There are 70 million people currently enrolled in Medicaid, a program that advances the equal opportunity and personal liberty of people nationwide. A majority of those people are women, and many are people with disabilities who rely on the program to live independently.
According to the Washington Post, “14.4 million fewer people [would be] enrolled in Medicaid by 2026” if Trump is able to phase out the Affordable Care Act’s Medicaid expansion and impose caps.
In Texas, children with disabilities are already experiencing the brunt of Medicaid cuts. When state lawmakers decided to sharply curtail Medicaid spending, many children were left without access to critical services. After “the state implemented $350 million in Medicaid cuts to speech, occupational and physical therapy,” the Associated Press reported, some clinics working with children with special needs had to shut their doors. Similarly devastating effects of Medicaid cuts could soon be felt nationwide.
As the ACLU’s Vania Leveille and Susan Mizner have noted:
Medicaid is the primary source of funding for the services that allow people with disabilities to live in their own homes and make their own choices about daily life, instead of being warehoused in institutions. Medicaid allows people who would otherwise languish in nursing homes and psychiatric hospitals to move to a community where they can work, play, and live, integrated with the rest of the society.
One study recently found that people with disabilities who live states that expanded Medicaid “are more likely to be employed than are those living in nonexpansion states.”
Medicaid cuts would also disproportionately affect women, preventing many from accessing maternity care and family planning services. Medicaid covers 75 percent of all publicly funded family planning services and nearly half of all births in this country. It serves approximately one in five women of reproductive age. Combined with the Senate bill’s provision to block use of Medicaid at Planned Parenthood, women who rely on Medicaid would be left with few options for care.
During the campaign, Trump repeatedly promised not to cut Medicaid. But his former economic adviser Stephen Moore gave away the president's intentions when he told CNN in May that enacting severe Medicaid caps was "central to our plan all along."
Unless we act now to save the program, the most vulnerable among us will be left to struggle even more.