Medicaid is the nation’s principal source of health coverage for low-income people, covering more than 52 million Americans, including senior citizens, people with disabilities, children, and pregnant women. It is a program jointly funded by the states and the federal government that reimburses hospitals and physicians for providing care to qualifying people with disabilities and people who cannot finance their own medical expenses. Medicaid was established in 1965 as a part of the Social Security Act. The program is voluntary for states, but provides federal matching payments of state Medicaid expenditures. The federal commitment to financing Medicaid rises automatically with state Medicaid spending. Depending on the relative “wealth” of a state, the federal government’s share of Medicaid costs ranges from 50% to a statutory maximum of 83%. The current concern is that as Medicaid rolls continue to expand, the deficit-ridden federal government will be less able to fund Medicaid spending. Further, it is expected that the cost of health care and pharmaceuticals will continue its current trend of rising faster than state tax collections. Because persons with disabilities have unique health needs, they are among the most costly Medicaid beneficiaries. As an increased focus is placed on limiting the growth in Medicaid spending and as the debate over the future of Medicaid intensifies, it will be critical to understand and protect the role that Medicaid plays in the health care system for people with disabilities. Open-ended financing and flexibilities in Medicaid have permitted states to innovate and improve the delivery of services to people with disabilities. In fact, many state Medicaid programs have gone far beyond federal minimum requirements in providing coverage of services to persons with disabilities, and states have been working to increase the availability of services and supports in the community to facilitate independent living.
The American Council of the Blind has concerns about projected changes to Medicaid funding including proposed cuts of up to $60 billion over the next 10 years. Those cuts may be accomplished through entitlement caps limiting federal spending on entitlements (i.e. Medicare and Medicaid) which, because of lack of funds would force the states to limit the number of Medicaid beneficiaries “on the rolls” or decrease the services provided. Another way that the federal government could alter its funding is through block grants which would change Medicaid away from an open-ended financing system resulting in a huge cost shift to states and an increase in the number of uninsured.
ACB believes that these measures run contrary to the partnership entered into between the states and the federal government, and oppose any changes that may put at risk the provision of quality healthcare to needy families and individuals with disabilities.