The Medicaid Cry(sis)

Like states around the country, Texas is suffering from a huge budget crisis. To fix this mess, legislators are looking to reduce the two largest line items on the government budget, Education and Health & Human Services.

HHS, which is funded by both state and federal coffers, has several components. The one which most directly affects people with disabilities is Medicaid. As many people with intellectual and developmental disabilities are unable to hold a traditional job, with traditional health benefits, Medicaid is critical for meeting their health care costs. In addition, this true “life support” also provides necessary attendants, job and life skills training, as well as the mechanism to live independently in the neighborhood of their choice.

This support is not cheap. Within Medicaid, 15% of the participants are people with disabilities, yet they make up 40% of the total spending. As non-government entities, such as business and the faith-based organizations, have chosen to abdicate care for people with disabilities to the government, this lifeline is understandably critical. in lieu of no alternative, it must be maintained.

People and families with disabilities have unique experiences to which most common families have little exposure. True dependence on another person for the basic needs of life creates fear in the individual, but an astounding level of stress for the caregiver. For each person with a severe disability, there are at least 4 other “traditional” people whose lives are directly affected.

Issues facing families with disabilities go far beyond the common concerns of picking kids up from school, worrying about which soccer squad they make, or even concerns about losing a job or making the monthly mortgage. Even in the most extreme cases of job and home loss, people with traditional skills can often scale down their consumption to fit their new circumstances, as the skills they have can usually transfer to a new profession. For people with severe intellectual disabilities, there is no room to “scale down”, as the only option to independence is seclusion in an antiquated state institution.

When trimming budgets, elected leaders often use a blunt sword instead of a precision scalpel. Wholesale reductions in Medicaid result in service providers going out of business, job training programs disappearing, and people forced to leave their homes and move to state institutions. In an ironic twist, the cost of institutionalization is actually three times higher per person than the cost of community support due to the excessive overhead the state creates.

Everyone needs a voice, and at some point in their lives, everyone needs help from a friend. To people with intellectual and developmental disabilities, The Arc of Dallas is that helping friend who provides a strong voice for people in North Texas.

--Clay Boatright

President, The Arc of Texas