Commentary: Cuts to Medicaid threaten services for disabled

“The moral test of government is how it treats those who are in the dawn of life, the children; those who are in the twilight of life, the elderly; and those who are in the shadows of life, the sick, the needy and (those with disabilities).” — Hubert Humphrey

By Lance Morehouse

Regardless of the fate of attempts to repeal and replace the Affordable Care Act (ACA) in Washington, D.C., services for thousands of people with disabilities in Washington State are at stake, especially as Congress considers cuts to Medicaid.

The ACA provides insurance coverage to millions of Americans who did not have coverage prior to its passage. Insurance companies cannot refuse coverage to people with pre-existing conditions. Many states, including Washington, took advantage of Medicaid expansion under the ACA to provide coverage to thousands more people with low and moderate incomes.

In our state, Medicaid funding provides so much more than health care! Impacts to Medicaid in the proposals currently being considered by our elected officials would be devastating to people with disabilities.

Through our state’s Medicaid waivers, community services such as personal care, residential supports, employment supports, therapies and assistive technology are provided to people with intellectual and developmental disabilities.

In the Developmental Disabilities Administration alone:

14,500 people receive personal care services to help with basic personal support needs such as toileting, bathing, meal preparation and ambulation;

8,000 people receive employment supports helping them earn over $48 million in wages, supporting our economy and providing a higher quality of life;

5,000 people receive residential supports to meet their daily needs and have a roof over their heads.

If repealed, services to thousands of older citizens and people with other disabilities will also be affected.

These community services help people live more independent and inclusive lives in the community and are much more cost effective than institutionalization or hospitalization. In the current Medicaid structure, for every $1 our state spends on community services, the federal government provides $1 in matching funds. If federal Medicaid funding is drastically reduced, our state would have to make difficult decisions on what we could afford to provide; even though there are already long waiting lists for some of these services.

People with intellectual and developmental disabilities will always be considered to have pre-existing conditions, so for those who lose Medicaid, the few plans offered that may cover them will have huge premiums, pricing them out of health care coverage altogether.

People with disabilities make up nearly 14 percent of the Medicaid population and account for 40 percent of the total costs. Any reduction in funding will disproportionately affect people with disabilities.

The health care proposal that passed the U.S. House of Representatives would cut $834 billion in Medicaid funding over ten years. The latest Senate version being considered is not much better, making $772 billion in reductions to Medicaid.

For more 20 years, I have worked alongside many state legislators and members of Congress addressing the importance of Medicaid and insurance coverage for people with disabilities. We have made great strides to ensure services and supports are available for people with disabilities and the passage of any of the new proposals will greatly reduce these services and limit people’s potential. People with disabilities rely on Medicaid as their primary source of health care and the support that they need to be contributing members in their communities.

Can there be improvements to the ACA? Definitely; but I hope it doesn’t have to be at the cost of people who rely on services and supports for basic human needs.

If you support the House and Senate proposals to repeal and replace the ACA, you are supporting reductions that will significantly impact people with disabilities right here in Snohomish County.

I know these issues firsthand, having been a father of two sons with significant disabilities who relied on these community services. As a father, an advocate, a provider of services and a resident of Snohomish County, I ask you to contact your senators and U.S. representative and urge them not to support the latest proposals.

For more information about the impacts to people with disabilities please go to

Lance Morehouse is executive director of Sherwood Community Services in Lake Stevens.

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