This post was written by Visiting Fellow Chris Jacobs and was originally published here.
On Tuesday, a series of groups representing individuals with disabilities organized a series of rallies protesting the House health-care bill and its proposed changes to Medicaid. The rallies, supervised by the Consortium of Citizens with Disabilities (CCD), encouraged advocates to “stand up for people with disabilities” and “join us in saying ‘no’ to over $800 billion in [Medicaid] cuts that will leave 10 million individuals at risk.”
However, the CCD version of events omits several inconvenient truths.
First, the CCD talking points claim that the House’s health care bill would “decimate Medicaid,” in ways that have “nothing to do with” Obamacare. But the Congressional Budget Office (CBO) estimate of the House bill, released late last month, found that over the coming decade, the legislation would reduce Medicaid spending by less ($834 billion) than if Obamacare’s Medicaid expansion had been repealed outright ($903 billion).
Unfortunately, the CBO estimate did not specifically delineate the spending reductions due to the phase-out of the Obamacare expansion versus the other Medicaid reforms (a block grant or per capita spending caps) in the bill. But the idea that repealing just some of the spending associated with Obamacare’s expansion would “decimate” the program seems hyperbolic in extremis.
How Expanding Medicaid Hurts Those with Disabilities
Second, repealing Obamacare’s Medicaid expansion would actually eliminate a major source of discrimination against individuals with disabilities. As I have previously written, the Medicaid expansion gives states a greater incentive to cover able-bodied adults under expansion than individuals with disabilities previously eligible for Medicaid. And states have done just that: Illinois cut medication funding for special needs-children on the same day it voted to expand Medicaid under Obamacare, and Ohio Gov. John Kasich cut eligibility for 34,000 individuals with disabilities, even while expanding the Medicaid program to the able-bodied.
Third, CCD did not speak out against Obamacare’s discrimination against individuals with disabilities prior to the bill’s passage. In a 14-page, single-spaced letter dated January 8, 2010, this coalition of disability groups said not one word about the fact that the proposed legislation gave state Medicaid programs a greater federal match to cover able-bodied adults than individuals with disabilities.
In fact, CCD not only did not object to the way Obamacare discriminates against individuals with disabilities, it wanted to expand that discrimination. The coalition called on Congress to expand Medicaid further up the income scale than the legislation signed into law. Had Congress done so, even more able-bodied adults would have qualified for a higher Medicaid match rate than individuals with disabilities—further entrenching Obamacare’s perverse incentives.
Let’s Be Clear: People’s Lives Are At Stake
Given this history, it’s more than a bit rich for CCD to be calling on Americans to “stand up for people with disabilities,” as it said nothing about an issue of critical importance to those individuals seven years ago. On the one hand, it might be unsurprising that individuals working for disability rights groups—with generally leftist political leanings—did not point out a key flaw in a bill that sought to accomplish the liberal dream of universal health insurance coverage for Americans.
But on the other hand, at least hundreds of individuals with disabilities have died awaiting access to Medicaid services since Obamacare’s enactment. These are just some of the more than half a million individuals with disabilities still on waiting lists for home-based personal care, even as millions of able-bodied adults obtain coverage under Medicaid expansion.
Those individuals might not think that living—or dying—on a Medicaid waiting list was a price worth paying to achieve liberal advocates’ shibboleth. And those advocates might rightly find their own political motivations questioned when they can muster all manner of self-righteous indignation over Republican Medicaid reforms yet say not a word when a Democratic president signs a bill that encourages states to discriminate against individuals with disabilities.
Earlier this year, one of my articles on this topic prompted the mother of an autistic child to e-mail me. Her son had just gotten off of a Medicaid waiting list. Having received messages from one CCD member organization, she worried about what might happen to his care if Congress repealed Obamacare. I told her that repeal would actually help her son—it would prevent states from prioritizing the able-bodied over special-needs children—and then concluded:
My personal view is that some disability groups have chosen to prioritize the general liberal goal of ‘universal health care’ rather than the specific needs of individuals with disabilities they’re supposed to represent. And I think that ultimately does a disservice to individuals like you and your son.
If CCD wants to represent its actual constituents—as opposed to the general wishes of the Left—then it should stop scaring individuals like this mother, and apologize for having stood by while Obamacare created an insidious form of discrimination against individuals with disabilities on Medicaid discrimination. That truly would be “standing up for people with disabilities”—a welcome change indeed.