Supports for Individuals with Disabilities Are at Risk

The American Health Care Act (AHCA), sweeping legislation that would undo historic health care gains, is being rushed through Congress by House Republicans. If passed, it would have devastating consequences for vulnerable populations, particularly people with disabilities.
Nearly 1 in 5 Americans has a disability. According to the Center for American Progress, 15 million people with disabilities receive health insurance through Medicaid. This enables them to attend work or school and live in communities rather than health care facilities. The AHCA would put all of this at risk by changing Medicaid’s financial structure. Instead of an ongoing federal commitment to share the cost of providing comprehensive coverage, states would receive capped funding—or “per capita caps”—for Medicaid. This would shift costs to states and force them to limit benefits and coverage, especially for those who need the most care, such as adults and children with disabilities. This week, the independent Congressional Budget Office estimated that, by 2026, the AHCA would cut federal Medicaid spending by 25 percent, as well as reduce coverage by 14 million people, compared to current law.
The AHCA would terminate the Community First Choice option, which provides states with enhanced funding for home and community based services (HCBS), starting in 2020. Provided as waivers under Medicaid, HCBS ensure individuals with disabilities receive the support needed to live in their own homes, rather than nursing homes or other institutions. The CBO estimates $12 billion in cuts to these services over 10 years—forcing people with disabilities out of their communities into a limited range of facilities. Additionally, the AHCA would eliminate critical benefit protections for individuals who gained coverage under Medicaid expansion. The Essential Health Benefits at risk include a range of mental health and substance use services, as well as rehabilitative services.
Living with a disability, or caring for a family member with a disability, can be expensive. The specialized supports and services are often costly and difficult to navigate. Medicaid is essential to care for individuals who need equipment and specialized services that private insurance doesn’t cover. The impact of these services is highlighted in the video below, developed by the Center for American Progress and The Arc.

It’s critical that we protect Medicaid services so that adults and children with disabilities are afforded the opportunity to live in—and strengthen—their communities.