Andy Miller // Georgia Health News
Atlanta, GA — The potential cuts in the Medicaid program, as outlined in the GOP health care bills, have a deeply felt meaning for Mitzi Proffitt and her family.
She’s employed by a nonprofit that provides services to Georgia families impacted by disabilities or special health care needs.
And at home, Mitzi arranges for help at her east Georgia home for her son, Joshua, 22, who has cerebral palsy and gets around with a power wheelchair.
“I live it and work it,’’ she says.
Joshua receives Medicaid services through a “waiver’’ program for people with developmental disabilities. Because of his physical limitations, Joshua gets help with dressing, eating and transportation, among other services, through the COMP waiver.
He now attends college. “He’s smart as a tack mentally,’’ Mitzi says. “He can talk but can’t move.”
The aid also allows her to work at the nonprofit Parent to Parent of Georgia.
So when the House Republican bill – and the somewhat different Senate version unveiled last week – outline cuts to Medicaid, Mitzi fears the potential impact on her son if the legislation becomes law.
Eventually, through a reduction or elimination of the waiver services, Joshua would be put in a nursing home, she says.
The House bill is projected to cut Medicaid by more than $800 billion over 10 years. The Senate bill, experts say, will produce even deeper long-term cuts to Medicaid.
Both the House and Senate health bills would fundamentally change the way the federal government pays its share of Medicaid costs, establishing a per-person limit on spending that would adjust annually for inflation.
The bills would also effectively end Medicaid expansion, an option for states under the current Affordable Care Act. (Georgia has not opted for expansion.)
Chances of Senate passage of a health care bill remain uncertain, with a vote expected this week.
Medicaid currently covers roughly 2 million Georgians, most of them children. It also pays for more than 70 percent of the nursing home residents in the state, and covers more than half of the childbirths in Georgia.
Overall, people with disabilities and seniors make up 25 percent of Medicaid enrollees in Georgia, and account for about 60 percent of the program’s costs. The proposed caps on Medicaid spending “are a cut to the people who are the most vulnerable,” says Alison Barkoff, director of advocacy for the Center of Public Representation, in Washington, D.C.
“People with disabilities and seniors will be disproportionately hurt,” she adds.
This includes two waiver programs that provide home- and community-based services for about 12,500 Georgians with intellectual or developmental disabilities. Nearly 9,000 others are on waiting lists for those services in Georgia.
The Proffitt family, who live in Brooklet in Bulloch County, waited about eight years before being approved for the waiver services for Joshua. He’s now allowed about 60 hours a week.
“We have to fight every year’’ to maintain this help, says Mitzi, who also chairs the Georgia Council for Developmental Disabilities.
Its executive director, Eric Jacobson, says the waiting list will naturally grow under the proposed Medicaid cuts. “People who are getting services will potentially lose some or all of those services,” he adds. The legislation represent a “draconian cut to people with disabilities.”
That sentiment was reflected in a “die-in” protest last week outside the office of Senate Majority Leader Mitch McConnell (R-Ky.). About 50 people with disabilities, many in wheelchairs, were arrested on charges of obstructing a Capitol hallway.
The Kaiser Family Foundation says Medicaid covers more than three in 10 non-elderly adults with disabilities, including people with physical disabilities, such as cerebral palsy, multiple sclerosis, and traumatic brain or spinal cord injuries; intellectual or developmental disabilities such as Down syndrome and autism; and mental illness.
Medicaid cuts would mean that governors and state legislators, facing huge reductions in federal Medicaid funding, might decide to raise taxes to offset the revenue loss, or cut back on eligibility or services, or reduce payments to medical providers, experts say.
Including residents in nursing homes, Medicaid spending per enrollee for people with disabilities is substantially higher than for those without disabilities. That’s due to their greater health needs and reliance on Medicaid for expensive but necessary services, the Kaiser Foundation notes. More than half of Georgia’s Medicaid dollars go to the elderly or people with disabilities, according to the state’s Department of Community Health.
Laura Harker, health policy analyst at the Georgia Budget and Policy Institute, says the Medicaid waivers “allows the person receiving Medicaid benefits to pursue a normal life and boosts the general quality of life of those families.”
Georgia’s home and community-based services are an optional Medicaid benefit, putting it a greater risk of cuts under the U.S. Senate proposal, Harker says. Georgia stands to lose between 3,000 and 7,000 home health aide and personal care aide jobs if these services are reduced.
Jacobson also notes that Georgia schools receive million of Medicaid dollars to provide services for special education students and pay school nurses and therapists to provide treatment and screenings for all children.
Mitzi Proffitt fears that under the Republicans’ plan, waivers would be targeted for cuts. That could sidetrack Joshua’s plans to become a sports broadcaster, she says.
“He’s had to fight for his diploma,’’ she says. “He wants a job.”
“It’s about quality of life.”