While many are concerned about the direct cuts the One Big Beautiful Bill Act, or the federal budget, makes to Medicaid, advocates worry about how the states will make up for these cuts. The nonpartisan policy institute Center for American Progress has pointed out that previously when federal funds to states for Medicaid have been lost, states have attempted to make up that loss funding by cutting programs.
One of those Medicaid programs is Home and Community Based Services or HCBS. These programs vary state-by-state, but usually you focus on providing supports that allow people to stay in their communities. We spoke with disabled New Yorkers about their concerns with federal cuts potentially triggering state-level changes.
TRANSCRIPT
Emyle Watkins: Hi, I am Emyle Watkins and this is the Disabilities Beat.
Hannah Brecher: I have learned that it's not just one thing, it [Medicaid] basically it helps me with my entire life.
Emyle Watkins: That's 35-year-old Hannah Brecher talking about Medicaid, and she's right. Medicaid covers a lot and isn't just health insurance. Brecher shared that when doctors discovered issues with her ankles, she could get treatment to walk better. When she was diagnosed with autism...
Hannah Brecher: I was diagnosed with autism in 2008 when I was 18 years old. I got therapy to be able to speak and to be able to do a lot of things, so Medicaid has really been there for me.
Emyle Watkins: But one aspect of Medicaid that doesn't get talked about as much is home and community-based services or HCBS. These programs vary state-by-state, but usually you focus on providing supports that allow people to stay in their communities. Brecher is able to access additional support, including a care coordinator through this program, but that's not all HCBS covers.
Mike Rogers: I use Medicaid for aid service. It helps me to do daily living. Like for example, I get help, and I'm not afraid to say any of this, bathing, I get help with food preparation. I also get help with dressing. Medicaid also pays for, I can't say all of it because I'm not sure, but I think it pays for all if not of a significant portion of my wheelchair.
Emyle Watkins: Mike Rogers is another self-advocate who relies on home and community-based services in New York.
Mike Rogers: What scares me the most is not knowing what fully is going to be affected and what does that mean down the road, because you always hear people say, "well, we are not going to, nothing will be cut for people with disabilities." That's always like a tagline. And then as we go further and further in implementation of things, we find out that oftentimes that's not true or it's done in incremental ways so that people think that you don't notice that it's happening.
Emyle Watkins: While many are concerned about the direct cuts the One Big Beautiful Bill Act, or the federal budget, makes to Medicaid advocates worry about how the states will make up for these cuts. The nonpartisan policy institute Center for American Progress has pointed out that previously when federal funds to states for Medicaid have been lost, states have attempted to make up that loss funding by cutting programs. Those cuts have included HCBS programs, dental programs, and even speech therapy for adults like what Brecher received.
Hannah Brecher: I feel like they want us to reopen institutions and put us away again when we just want to be out in the community. We want to be able to live our lives the way we need to.
Emyle Watkins: Advocates worry that the loss of any of these benefits could impact disabled people being able to live independently rather than in an institution or hospital. Brecher says that as someone with a learning disability, she worries about losing her HCBS-funded care coordinator who provides her the information she needs to make important decisions.
Hannah Brecher: I also have a learning disability so I can be perceived as ,not a know-it-all, but more of a being... if somebody was to harm me, I would have never known if that would happen. But my care coordination, what they would do is they would guide me to where I need to go and give me information. The thing is that with care coordination for us, it's definitely our lifeline.
Emyle Watkins: Both Brecher and Rogers say that while the cuts the federal spending plan makes our concerning, they worry about what we don't yet know, how states will decide to cope with these cuts, and if that will include sacrificing vital programs with an HCBS.
Mike Rogers: We cannot lose these things or we lose our freedoms.
Emyle Watkins: You've been listening to The Disabilities Beat from Buffalo, Toronto Public Media. You can listen to The Disabilities Beat segment on demand view a transcript and plain language description for every episode on our website at etpm.org. I'm Emyle Watkins. Thanks for listening.
