Skip to main content

Sign up for our newsletter.

Quality journalism. Progressive values. Direct to your inbox.

From the 93-year-old grandmother who needs an attendant to help her get out of bed, to the 24-year-old with Down Syndrome receiving a job coach, to the 6-year-old with a disability whose parents need support paying for skilled nursing care in their home—the Medicaid program is critical to ensuring the independence and freedom of disabled people of all kinds. (Photo: Pixabay/CC0)

Trump’s Plan for Medicaid Would Decimate Services for People With Disabilities

Ari Ne’eman

 by TalkPoverty.org

As Congressional Republicans careen face-first towards the repeal of the Affordable Care Act, another threat is taking shape that promises to devastate the services that seniors and people with disabilities need. In addition to rolling back the health care law, and the Medicaid expansion that came with it, the Trump administration has announced its intention to turn what is left of Medicaid into a block grant.

Most Americans see Medicaid as only a health insurance program, but it is also the main source of funding for a wide variety of disability and aging services that keep people out of institutions. From the 93-year-old grandmother who needs an attendant to help her get out of bed, to the 24-year-old with Down Syndrome receiving a job coach, to the 6-year-old with a disability whose parents need support paying for skilled nursing care in their home—the Medicaid program is critical to ensuring the independence and freedom of disabled people of all kinds.

“Block-granting” the program will transform it from a guaranteed benefit for low-income Americans and people with disabilities to an annual lump sum payment to states that is not tied to the need for services. If an increasing number of people needs these healthcare services, a block grant will not adjust to meet rising demand.

A block grant will not adjust to meet rising demand.

In addition, under the current Medicaid program, the federal government matches each dollar spent by states, enabling policymakers to make new investments toward eliminating waiting lists and broadening available services. However, without the guarantee of matching funds, states will not be able to sustain existing services—much less expand them to meet the tremendous unmet need in the disability community.

In fact, previous block grant proposals resulted in a loss of approximately 1 trillion dollars of federal investment in Medicaid over the next decade.

Additionally, the Trump approach would diminish the federal government’s historic role in using Medicaid funds to deinstitutionalize seniors and people with disabilities. For nearly 20 years—since the Supreme Court ruled in Olmstead v. L.C. that people with disabilities have a right to access supports in the community—federal policymakers have used Medicaid dollars to reward states that moved people out of institutional facilities and instead offer in-home services and supports.

These efforts depend on the federal government using innovative programs like Money Follows the Person. This program helped more than 63,300 people with disabilities leave institutional settings by providing an enhanced federal match rate to states to cover the full cost of supporting a person in the first year after they leave an institution.

In the absence of a federal role in Medicaid to promote community living, people with disabilities will find themselves at greater risk of institutionalization—despite the fact that they overwhelmingly express a preference for living in their own homes and communities.

As we fight back against Donald Trump’s assault on so many different communities, people with disabilities supported by the Medicaid program deserve our full advocacy and activism too.


© 2021 TalkPoverty.org

Ari Ne’eman

Ari Ne’eman is the CEO of MySupport.com, an online platform helping people with disabilities, seniors, and families to manage their in-home services. From 2006 to 2016 he served as president of the Autistic Self Advocacy Network, and from 2010 to 2015 he was one of President Obama’s appointees to the National Council on Disability.

We've had enough. The 1% own and operate the corporate media. They are doing everything they can to defend the status quo, squash dissent and protect the wealthy and the powerful. The Common Dreams media model is different. We cover the news that matters to the 99%. Our mission? To inform. To inspire. To ignite change for the common good. How? Nonprofit. Independent. Reader-supported. Free to read. Free to republish. Free to share. With no advertising. No paywalls. No selling of your data. Thousands of small donations fund our newsroom and allow us to continue publishing. Can you chip in? We can't do it without you. Thank you.

GOP Silence on Trump's Call to Axe Constitution Reveals 'Full Embrace of Fascism': House Dem

"Last week the leader of the Republican Party had dinner with a Nazi leader and a man who called Adolf Hitler 'great,'" said Rep. Bill Pascrell. "Yesterday Trump called for throwing out the Constitution and making himself dictator."

Kenny Stancil ·


Protesting Fuel Poverty, People Tell UK Government to 'Keep Everyone Warm This Winter'

As energy bills—and fossil fuel profits—continue to soar, demonstrators around Britain demanded immediate action from Prime Minister Rishi Sunak and members of Parliament.

Kenny Stancil ·


'Turn Off the Tap on Plastic,' UN Chief Declares Amid Debate Over New Global Treaty

"Plastics are fossil fuels in another form," said U.N. Secretary-General António Guterres, "and pose a serious threat to human rights, the climate, and biodiversity."

Kenny Stancil ·


EPA Urged to 'Finish the Job' After Latest Move to Protect Bristol Bay From Pebble Mine

"Local residents, scientists, and the broader public all agree that this is quite simply a bad place for a mine, and it is past time for the EPA to take Pebble off the table permanently," said one activist in Alaska.

Jessica Corbett ·


'Zero Tolerance for Corruption': Grijalva, Porter Demand Answers on Alleged Trump Pardon Bribery Scheme

The Democrats believe a real estate developer donated to a Trump-aligned super PAC in exchange for the pardons of two other men.

Julia Conley ·

Common Dreams Logo