Updates in the Media

Although AHCA is Dead,

Medicaid is Not Out Of The Woods Yet:

Stay Informed, Set Your Strategy, Take Action!

Take Action

At APSE, we believe that work is a meaningful part of living a healthy, productive, and full life. The Employment First movement is dedicated to making employment a reality for every American adult. For millions of Americans with disabilities, having access to healthcare and other employment services is crucial to having the ability to work in their communities.

There is no doubt that the Medicaid expansion, a key provision of the Affordable Care Act (ACA) that passed in 2010, has enabled people with disabilities to lead more productive lives. Although the ACA survived the most recent threat by House Republicans to repeal and replace it with the American Health Care Act (AHCA), there is no guarantee that Medicaid won’t end up back on the chopping block during future negotiations.

Fortunately, the Speaker of the House did not have the support to bring the AHCA to the floor for a vote and in-fighting among Congressional Republicans has ended discussion of repealing the ACA anytime soon. But we cannot afford to mistake this dodged bullet for a clear victory.

Policy experts expect that Republican leaders will continue to consider changes, such as shifting from a guarantee of federal funds for Medicaid to sending a chunk of money—either in the form of a “block grant” or a “per capita” allotment—to states. This means that it would be up to state officials to determine how and whom to cover.

Additionally, last month, the US Secretary of Health and Human Services urged governors to make changes to Medicaid. Currently, states decide how to spend federal Medicaid funds with approval from Washington. But administration officials have suggested that states begin to prepare their Medicaid recipients for transitioning to commercial health insurance.

So, while the threat to Medicaid from the AHCA may be over for now, it remains important to stay engaged and to encourage your local business communities to consider how decisions in Washington affect daily lives closer to home.

Here’s what you can do to stay engaged during this time of legislative limbo:

1. Stay Informed

Major Proposed Reforms:

  • REPEAL at least some—if not all—portions of the ACA, including Medicaid expansion. A full 42% of Medicaid funding currently pays for services and supports for individuals with disabilities. Medicaid is also the primary funder of employment services and supports or these individuals. Even though the administration isn’t making repeal a priority, there’s no guarantee that Congress won’t find other creative ways to weaken the ACA or cut the Medicaid expansion.
  • CHANGE the way federal Medicaid funding flows to states. Currently, federal funds are allotted to individual Medicaid programs in each state. Proposed reforms include “block grants” or “opportunity grants” where the federal government would pay out a lump sum to each state. The state would then distribute the funding as it sees fit. A second funding alternative under consideration is “per capita caps.” This means that the federal government would set a limit on how much it contributes for each Medicaid enrollee. Advocates worry that per capita caps lack the spending flexibility to meet the needs of so many people with disabilities. Keep in mind that all Medicaid Home and Community-Based Services (HCBS) are optional services.
  • REDUCE the overall amount of federal Medicaid funding. States contend that they would not be able to make up for this funding gap without significant federal support.

APSE urges everyone to monitor how reforms may affect the programs most important to people with disabilities in their local communities. ACA and Medicaid provisions that have been most important to the APSE Community include: the Medicaid expansion, dependent coverage, long term services and support (LTSS), Community First Choice (CFC), Home and Community-Based Services (HCBS), and intellectual disabilities/developmental disabilities waivers.

How can you play a role? 

  • Talk to your neighbors about Medicaid: You are informed about Medicaid because it directly affects you and your loved ones. Remember that many of your friends and neighbors may be less informed. Find gentle ways to show them what Medicaid means to you. 

House GOP Passes Bill to Gut ACA, APSE is Taking the Fight to the Senate (May 4, 2017)

2. Set Your Strategy

My son has Down syndrome. The GOP’s health-care bill scares me to death. (May 18, 2017)

3. As a national organization...

APSE continues to be a strong voice for federal programs and legislation that support Employment First. The most effective voice of all, however, is a motivated constituent who takes the time to contact his/her legislator and weigh in on an issue. Grassroots advocacy efforts can make a big difference.

APSE provides tools—including APSE Action Alerts—to guide you when you contact members of Congress to discuss issues that matter to people with disabilities. We urge you to take advantage of these tools…and let us know how we can help!

Updates from APSE

  • Attend Town Halls: Express your concerns in person to your representatives and local politicians. Encourage friends to go with you. Numbers are key. Be sure to plan ahead: A reminder that your members of congress are on recess until April 23rd. A full calendar can be found here.  
  • Submit an Op-Ed to your Local Paper: Detail your personal story and how proposed reforms would impact you or someone close to you. 
  • Approach Your Legislator (state or federal): Attend local events and tell your story. If possible, get a picture with your legislator and post on social media.  
  • Request meetings with your state governor’s office: Meet with anyone in your governor’s office who will listen to you. Ask for their thoughts about how to best advocate for people with disabilities.
  • Build a coalition: Find other groups with similar values and issues (e.g., aging, poverty, healthcare providers). Talk about what types of advocacy have worked for them and how you can work together for a common cause.
  • Use social media: Put a human face on the issue by creating videos to post on social media channels. Send your videos to local TV and radio stations. This is an easy way to potentially reach millions.
  • Plan a Take Your Legislator to Work day event with your APSE Chapter and/or within your organization to show your policy makers the importance of employment in your community.

My Medicaid, My Life (May 3, 2017)

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