‘You Will Kill Me’: Disabled People Call BS On Republicans' Medicaid Cuts

WASHINGTON — Rep. Gary Palmer (R-Ala.) was in the middle of explaining why vulnerable Americans wouldn’t lose benefits as a result of the GOP’s proposed changes to Medicaid when a scream interrupted him.  

“You will kill me,” a woman in the audience of the House Energy and Commerce Committee room yelled. She added in a loud voice that she is HIV-positive and her drugs cost $10,000 a month. Palmer waited silently as police pulled and pushed her wheelchair from the room. 

Americans with disabilities, many in wheelchairs, were an overwhelming presence at the committee meeting where Republicans jump-started the process of passing legislation with significant cuts to Medicaid, which covers health care costs for 70 million Americans. Police arrested 26 people for interrupting the meeting or blocking the hallway. 

Republicans spent the length of the meeting insisting the cuts, which are part of the legislation encompassing President Donald Trump’s biggest domestic policy goals, would preserve Medicaid for the people who really need it, especially those with disabilities. 

“Our priority remains the same: strengthen and sustain Medicaid for those whom the program was intended to serve: expectant mothers, children, people with disabilities, and the elderly,” committee Chair Brett Guthrie (R-Ky.) said in his opening statement. 

But the disabled people who came to protest Tuesday disagreed and were worried they could lose their benefits despite what Republicans say. The Congressional Budget Office has said the bill’s various provisions affecting both Medicaid and subsidies for private health insurance would result in at least 8.6 million fewer Americans having health insurance by 2034, saving the government more than $700 billion on health costs.

The savings would result from a combination of changes, including state funding reductions, new “work requirements” limiting benefits for unemployed able-bodied adults, and increased eligibility checks on those who got Medicaid coverage thanks to the 2010 Affordable Care Act expansion, commonly known as Obamacare.

People with disabilities would be exempt from the work requirements, as well as from increased eligibility checks. Disabled people and their advocates said, however, that they could be harmed by the overall reduction in federal Medicaid spending and increased pressure on states to cut costs and scrutinize enrollees. 

Kim Musheno, a Medicaid expert with The Arc of the United States, a civil rights organization for people with disabilities, said increased eligibility checks and work requirements are intended to push people off Medicaid. 

“It’s just another way of reducing people on Medicaid because they might miss the mail, or, you know, they might fill out the form wrong,” Musheno said. “All of these proposals are for one reason: to make savings. Savings are cuts.” 

Julie Farrar, 56, traveled from Albany, New York, to attend Tuesday’s hearing as part of National ADAPT, a group advocating for Medicaid funding for long-term services and supports (LTSS).

Many people with disabilities rely on in-home caregivers funded by LTSS programs for help with daily tasks, including things like changing, toileting and getting ready for work. Farrar uses a wheelchair and receives daily assistance in her home.

“All of the people here are on Medicaid, all of the people here are fighting for our lives,” Farrar said. “Some of the people that I know will die without their home care services.”

If states face funding pressures as a result of federal cuts, they might scrutinize their home-based services, as those make up a significant portion of overall Medicaid costs but often aren’t required under federal law, said Anthony Wright, director of Families USA, a nonprofit consumer health advocacy group. 

“It’s not like the states want to cut home and community based services, but if there is a [federal] cut of a significant size, then they will be forced to look at cutting anything that’s not nailed down,” Wright said. 

As far as Republicans in Congress are concerned, if a state decided to cut services as a result of the changes under consideration, it would be the state’s decision — not theirs. One provision of the bill would reduce federal funding for states that use their own money to provide Medicaid services to the children of undocumented immigrants. If states want to lose that funding, that’s their choice. As House Speaker Mike Johnson (R-La.) put it Wednesday, “We’re not cutting Medicaid.”

That’s why eligibility checks and work requirements have been some of the least controversial proposals for both Medicaid and the Supplemental Nutrition Assistance Program among Republicans. Their thinking is that if someone doesn’t get a job or can’t prove they meet the requirements, either that person isn’t eligible or has made their own personal decision to become ineligible.

“The intention is to make sure that people that aren’t eligible are no longer on the program, and that’s not out of mean-spiritedness. It’s out of a desire to preserve the program for the people that are eligible,” Rep. Jay Obernolte (R-Calif.), a member of the Energy and Commerce Committee, told HuffPost.

There’s not much question that increased paperwork can lead to reduced enrollment. When the federal government first allowed states to experiment with limits on benefits for able-bodied adults, the work requirement in Arkansas led to reduced enrollment partly because of paperwork issues, confusion over the rules and the state’s own failure to contact affected enrollees. 

Guthrie said Republicans have no interest in following the Arkansas example. “We don’t want people to lose Medicaid, who are eligible for Medicaid, because they don’t fill out the paperwork,” the committee chair said, noting that the bill doesn’t have the kind of monthly compliance checking that Arkansas tried.  

Amid disruptions from disabled activists on Tuesday, Guthrie and other Republicans said Democrats were lying about what’s in the bill, especially the potential impact of the Medicaid changes on people with disabilities. 

“I am sorry that so many people in the media and on the left have lied to you about what’s in this bill,” Rep. Dan Crenshaw (R-Texas) said. “That’s not fair for people to be lied to and to be scared, on purpose, for political reasons.”