There is good reason why people with disabilities have been protesting senators’ offices and holding sit-ins across the country all the way from Washington, D.C., to Missoula, Montana. For folks like myself who receive personal care and services at home and in our communities under the Community First Choice (CFC) program and the Home- and Community-Based Services (HCBS) waiver, not only is health care in jeopardy — so is life and liberty, literally.
The Senate health care plan, the Better Care Reconciliation Act (BCRA), would create additional barriers for people with disabilities and seniors to access affordable, or even adequate, health care.
Under current law, Medicaid is a federal-state financed partnership. Montana is able to respond to health care needs as they change over time, as well as react swiftly in the event of a natural disaster or epidemic to meet emerging needs.
The current Senate health care bill restructures Medicaid financing to a per capita cap system, which imposes an arbitrary, fixed amount of federal spending per beneficiary. Beginning in 2020, that change would cut federal Medicaid funding immensely, with the cuts growing each year. The cuts would continue to deepen in coming decades, rising to a 35 percent cut by 2036, according to the Congressional Budget Office.
Per capita caps shift the financial burden to individual states. Montana would likely have to make cuts that seriously harm beneficiaries, such as restricting eligibility, reducing services, cutting payments to providers (something that is already happening), or a combination of all three approaches to rationing care.
Let’s be clear: “Rationing care” is simply a way of saying “limiting health care services to only those who can afford to pay.”
Services such as CFC, HCBS waiver and other community-based supports are considered…