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Are We Reforming or Gutting Medicaid?

June 23, 2017

Are We Reforming or Gutting Medicaid?

There seems to be a growing stereotype among the general public piled on by political commentators and some Congressional leaders that people who “collect” SSI and are “on” Medicaid are scamming gamers who spend their time doing nothing more than work to avoid working. The stories about people abusing Medicaid always receive attention. The prejudice is that they are figuring out how to fraudulently con government services they do not need and are ultimately swindling taxpayers’ money. Individuals who disregard the purpose of the best-intentioned social programs exist. But this fact does notjustify undermining in wholesale fashion the social safety net that supports thousands and thousands of individuals who have disabilities, seniors and others who require a safety net. That Medicaid equates to wasteful spending is at best nothing more than another sound bite.

Medicaid funding covers a very wide range of folks with disabilities. It spans from a person with Down syndrome who works in a law office or at the local grocery store to those with disabilities who have difficulty conveying complex concepts and have chronic health conditions. Some need support to become gainfully employed and maintain employment while others require complete and total medical care.

Many people with significant disabilities who have been diagnosed as having autism or developmental or intellectual disabilities (historically labeled mental retardation) or with cerebral palsy who may also use a wheelchair are Medicaid recipients and they are not cheaters. In fact, they don’t want to be dependent and impoverished. They want to work and live like any other American. They want jobs and a path to economic self-sufficiency.

For those who do receive Medicaid funded services, direct caregivers work tirelessly for roughly $10 an hour to provide these supports. In our quest to “reform Medicaid,” we have forgotten, or we are choosing to forget, that the very safety net that Congress is proposing to unravel is the one built specifically for these friends, family members, neighbors and loved ones who have disabilities.

Our organization and many others like ours have placed thousands of people with disabilities who have been discriminated against into jobs. Many of those jobs were not high paying jobs, however, they involved honest work. The reality is that people with disabilities are faced with a double-edged sword. They often need to overcome the assumption of a typical employer who simply believes they cannot do the job. If they are turned down, and turned down repeatedly, then they are confronted with too many politicians and members of the general public saying they are looking for a hand out from Medicaid.

We should not dismember Medicaid as the low hanging fruit to reduce the deficit. It is possible to reform systems not only to support, but also to promote and invest in people with disabilities. The truth is our nonprofit spends more time documenting the care than providing it because of governmental regulations. If Medicaid is to be reformed, we need to re-direct public resources to provide supports that are better, but which are not necessarily more expensive. There are states in our country where people live in institutional settings that would remind one of a third world country, and yet these settings are very expensive. The federal government must incentivize states to close these institutions, large supported living centers and large nursing homes that simply are not necessary or conducive to the provision of quality assistance.

As some rush to thoughtlessly “slash Medicaid”, please remember those who wish they did not have to rely on these programs. All families want what is best for their loved ones, regardless of their disabilities. They just ask that persons with disabilities do not become an easy target to toss aside without consideration of the consequences.

Robert Stack
President and CEO of Community Options, Inc.

About Community Options, Inc.:

For 28 years, Community Options has developed housing and employment programs for people with disabilities – serving thousands of people through over 40 offices across 11 states. Community Options provides advocacy assistance to empower people with disabilities because all people – regardless of ability level – should live and work in the community with dignity, choice and self-determination. For more information please visit our website: and to follow along with the ComOpCares campaign, search #ComOpCares on Facebook, Twitter and Instagram.