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Op-Ed: No Government Shutdown for Now, but Medicaid Remains at Risk

The fight to preserve Medicaid is far from over. In fact, it is just beginning

Kevin Casey
Kevin Casey

While federal lawmakers avoided a government shutdown this fall, the next budget battle is just months away. Because Congress approved only a short-term fix, leaders will need to once again negotiate a spending plan and the debt ceiling.

Despite the recent bipartisan deal, Medicaid remains a primary target for budget cuts.

People with disabilities, advocates, and concerned citizens deserve some hard-earned praise for defeating threats to Medicaid this summer. Thanks to their success in reaching lawmakers, millions of people were not cut off from this critical lifeline.

But the fight to preserve Medicaid is far from over. In fact, I believe it is just beginning.

Medicaid is much more than a health insurer for struggling families, people with disabilities, and senior citizens. For those with developmental disabilities, such as autism, Down syndrome, cerebral palsy, and other life-long disabilities, Medicaid provides access to in-home, workplace, and transportation supports — and much, much more.

It is a bridge to independence, both financial and social, for people with developmental disabilities and their families.

So how does this short-term budget and any deal that might come in the near future affect Medicaid and the people who depend on it? The answer is different, though equally undesirable, for three possible scenarios.

Continuing resolution

Congress rarely passes a budget when it should. Instead, our representatives usually opt for what is called a continuing resolution. This stopgap measure is meant to keep the lights of government on for a bit longer, until the next showdown.

To few people's surprise, this is exactly what happened in early September. Although it is business as usual, even a continuing resolution places Medicaid and its recipients in danger.

For one, continuing resolutions keep the money for programs like Medicaid flowing at or near the existing rate. That is a problem because even when Medicaid funding is stagnant, people lose vital services. Last year's allotment simply could not cover inflation and the number of new beneficiaries.

A continuing resolution also guarantees another budget fight on Capitol Hill. The next round will take place in December, before the year is out. This move essentially keeps Medicaid as a political football, still at risk of deep cuts by federal lawmakers.

Government shutdown

Experts did not expect the government to freeze over in October, the start of the next fiscal year — and they were right. But it remains an option in the future, and one with dire consequences for Medicaid beneficiaries.

When the government grinds to a halt, all employees but those deemed “essential” are sent home. The furloughed typically include staffers who process paperwork for various programs. A shutdown could keep Medicaid administrators from working, forcing serious delays for new members and applicants.

Medicaid payments to healthcare providers would continue as normal. The question is, for how long. Just one month into a government shutdown, the money could dry up, barring any special protections put in place by our lawmakers. If funding were to stop, an untold number of people could lose access to care and more, if only temporarily.

Of course, a government shutdown would not safeguard Medicaid from cuts that are already on the table.

A budget passes The president's budget proposal includes over $600 billion in cuts to Medicaid over the next decade. By all accounts, that would decimate the program. Millions of people would lose coverage, sending people with developmental disabilities and their families into a spiral.

It is highly unlikely that such deep, foundation-shaking cuts will come to fruition this year. Even so, such funding decreases are on the table; and even smaller cuts — by 10 percent, 5 percent, or even 2 percent — would put an incredible amount of strain on a system that is already tight on funds.

Imagine if you had to choose between working or looking after your adult child with autism. Paying your bills or making sure your loved one could continue to see friends, socialize, and learn. Covering your own mortgage or keeping your child in a supportive, independent-living facility.

Many Americans already face these quandaries. Many more will know this pain if Medicaid spending remains flat or, worse yet, is cut.

We must continue to teach our elected officials and neighbors about Medicaid’s crucial role in American life — especially for those with developmental disabilities. Continued vigilance is the only way we can protect our families and friends.

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