This April marks the 9th Medicaid Awareness Month, and Donald Trump and Congressional Republicans have chosen to spend it slashing coverage and hiking costs for Americans with disabilities. Donald Trump and Republicans slashed over $1 trillion from Medicaid and the Affordable Care Act (ACA), ripping coverage from more than 15 million people and forcing rural hospitals to close, all to give massive tax breaks to billionaires and big corporations. As a result, people with developmental disabilities are losing access to the services that make everyday life easier, from doctor’s visits and prescription medications to therapies and home- and community-based services. These cuts aren’t just numbers on a page. They are a direct threat to the health, independence, and dignity of millions of Americans with developmental disabilities, their families, and the caregivers who support them. For millions of families, the loss of these services is nothing less than a crisis.
By the Numbers
- Over 1 in 3 Americans With Disabilities Are Covered by Medicaid. Over 1 in 5 of Medicaid enrollees report having a disability and the program covers around 75 percent of services for people with intellectual and developmental disabilities are covered by the program.
- Up to 1 in 4 U.S. Adults Have a Disability. Over 70 million American adults have some type of disability. Medicaid covers 41 percent of nonelderly adults with disabilities, including adults with physical disabilities, developmental disabilities, brain injuries, and mental illnesses.
- 15 Million Non-elderly Adults Are Enrolled in Medicaid Due to at Least One Disability. 15 million people under age 65 enrolled in Medicaid qualified as a result of a disability determination. Other individuals with disabilities may qualify for Medicaid due to age, pregnancy, or income.
- Medicaid Covers More Than Half of All Long-Term Care. The Medicaid program provides more than half of all long-term care in the United States, which includes essential home- and community-based services for people with disabilities. 61 percent of our nation’s spending on long-term care is paid for by Medicaid.
- 1 in 4 Americans With Disabilities Face Cost Barriers to Accessing Care. 1 in 4 adults with disabilities has had an unmet health care need in the past year due to high costs; this is something that will only be exacerbated as Medicaid cuts hit states.
Republican Budget Cuts Are Forcing States to Slash Millions of Dollars in Disability Programs. Thanks to Republicans slashing Medicaid funding, states have been put into an impossible situation: cut state funding for Medicaid even more or increase costs to pay for the programs. Idaho has just passed legislation cutting over $22 million from its Medicaid disability budget; in other states, like Iowa, taxes have had to be raised, and even still, advocates worry that disability cuts may be in the near future. Families with children with disabilities in Arizona and Colorado are also feeling the pain of GOP cuts.
Draconian Work Requirements Will Keep Millions From Accessing Vital and Lifesaving Health Care. Around half of all working-aged adults on Medicaid will be at risk of losing coverage thanks to Republican-forced work requirements, most of whom experience “greater physical, neuropsychological, and functional burdens” than those who will keep their coverage. While technically there is a requirement in place to exempt “medically frail” individuals, the reality on the ground as seen by Nebraska’s rollout of their work requirements is that disabled people will be lumped into the work requirements until a team looking at diagnostic codes maybe finds them; Nebraska is also proposing a nearly $152 million cut in the state’s health and human services, where this team looking for disabled Medicaid enrollees will be based out of.
Trump’s Medicaid Cuts Will Increase Wait Times by Years for Those With Developmental Disabilities Seeking Health Care. States like Colorado have been stuck with the bill after Republicans slashed $1 trillion from Medicaid. By having to cut costs and raise prices to maintain a functional state budget, those with developmental disabilities requiring 24-hour care may now be put on a 14-year waitlist, according to new budget proposals. Tens of millions in funding could be cut. Children with developmental disabilities, living with their parents and requiring full-time care, would potentially lose their coverage once they turn 18, and the state will double the existing waitlist time. This will lead to preventable deaths, worse care, and more expensive coverage for families, all so Republicans can provide a tax break to their billionaire buddies.
Hundreds of Thousands of Americans With Disabilities Are Stuck Without Coverage in States That Have Refused to Expand Medicaid. 10 states have refused to expand Medicaid under the ACA, stranding many low-income adults in the Medicaid coverage gap. As a result, over 265,000 Americans with disabilities with incomes below the federal poverty level are ineligible for Medicaid or ACA marketplace assistance in these states. Over half of these individuals reside in Texas or Florida, and adults with disabilities form at least 20 percent of those in the Medicaid coverage gap in Alabama, South Carolina, Kansas, Tennessee, and Wyoming.
Slashing Medicaid Puts Those With Disabilities in Expansion States at Risk. According to a 2021 study, individuals with disabilities living in Medicaid expansion states are more likely to be employed than those living in states that have not expanded the program. Medicaid expansion helps adults with disabilities gain quicker access to coverage without waiting for a disability determination, which can take years and lowers overall costs. 1 in 4 working-age adults with a disability has an income that is below the federal poverty line (FPL) ($14,880 for an individual, and $23,280 for a family of three on average in 2022). In 2022, CMS adopted rules to lower maximum out-of-pocket costs by $400. Now, due to Trump and Republican cuts to Medicaid, states like Idaho and Oklahoma are considering repealing Medicaid expansion entirely and other states are being forced to either raise taxes or cut other programs to make up for the increased costs.
