Trump’s Plan to Issue Block Grants Threatens Services for Individuals With Developmental Disabilities

The Trump administration is talking about fundamentally changing the Medicaid system by moving to block grants.  While few details have been released, such a shift may mean significantly less funding for Medicaid which funds many of the services provided to individuals with developmental disabilities, from healthcare to home and community-based services. Kellyanne Conway, Trump’s counselor, recently confirmed in an interview with NBC’s “Sunday Today” that block grants will be a key piece of the president’s effort to replace the Affordable Care Act.

Currently, Medicaid programs are administered by the states, but they must meet certain federal requirements. In exchange, states receive matching grants from the federal government, with no set cap. Under a block grant system, however, states would likely get a finite amount of federal dollars for their Medicaid programs and more autonomy to set rules affecting everything from eligibility to coverage.

Such a shift, however, worries disability advocates and is making providers of home and community-based services apprehensive.

According to Marty Ford, senior executive officer for public policy at The Arc, shifting to block grants could lead to eligibility changes, coverage cutbacks and longer waiting lists for Medicaid home and community-based services waivers, among other consequences. “The reality is, this would be done to cut federal funding,” Marty Ford said. “States generally do not have the ability to run a deficit under their constitutions so that puts more pressure on making cuts to the program.”

According to Gabrielle Sedor, chief operations officer at the American Network of Community Options and Resources, which represents over 1,000 organizations providing services to people with disabilities, “We’re hearing a lot of apprehension because (providers) don’t know what to expect and they don’t know what the administration intends….With intellectual and developmental disability services, it’s almost completely funded by Medicaid, so when you talk about changes, the impact is very direct.”

Advocates say that the prospect of drastically altering Medicaid comes as the program is already under pressure, with waiting lists for services in most states and providers struggling with high staff turnover.  A block grant approach would likely exacerbate those issues.

Advocates said that they’re actively talking to lawmakers on Capitol Hill about the importance of Medicaid to people with developmental disabilities and they’re encouraging stakeholders to do the same.  According to Julia Bascom, executive director of the Autistic Self Advocacy Network,  such conversations are vital to educate lawmakers about how Medicaid serves people with disabilities, and change attitudes that view it merely as a ‘poverty program.’

Source for the article:“With Talk Of Medicaid Changes, Waiver Services May Be At Risk” by Michelle Diament, Disability Scoop, February 2, 2017