May 11, 2017

Disability in the time of 'Trumpcare'

How might proposed changes to the US healthcare system affect people living with disabilities?

Prior to becoming president of the United States, Donald Trump said his plan to reform the nation’s healthcare system would “take care of people”. But in the wake of last Thursday’s vote by the US House of Representatives, many Americans—particularly those living with disabilities—remain concerned about whether President Trump’s proposed American Health Care Act (AHCA) will leave them behind. This is because a Congressional Budget Office report estimates the bill will reduce federal spending to Medicaid, a government-funded insurance program for low-income individuals and people in need, by more than $800 billion over the next decade. Opponents of the new bill say it harms some of the United States’ most vulnerable populations due to provisions that could give insurance companies greater control over the coverage they’re obligated to provide.
At least 50 million adults in the US live with a disability, with associated healthcare costs estimated at nearly $400 billion annually, according to the US Centers for Disease Control. Under so-called “Obamacare”, President Barack Obama’s signature healthcare law, insurance companies were required to standardise benefits and were prohibited from denying coverage to people with pre-existing health conditions. Although disabled Americans comprise at least 14 percent of Medicaid’s total enrollment, they account for 42 percent of its spending “due to their greater health needs and more intensive service use”. Without proper funding to Medicaid, some people say they will be unable to have the in-home services that enable them to perform all the activities of daily living. Others, like Alice Wong, wonder if their disability might qualify as a “pre-existing condition”, making healthcare more expensive. Wong, founder of the Disability Visibility Project and co-partner of the #CripTheVote campaign, wrote that many people criticise Medicaid as a tax-consuming “entitlement program”, but for her and others, “Medicaid is more than a health care program. It is a life-giving program.”
Medicaid also provides approximately $4 billion to $5 billion in reimbursements to school districts to support special education services, leading some families to worry about whether their children will receive the accommodations necessary for their education. Proponents of the Trump’s healthcare bill, however, contend Obamacare only made access to healthcare “more expensive and less accessible” for families. Washington State Representative Cathy McMorris Rodgers, whose son has Down syndrome, voted for the AHCA, saying it “establishes a program to provide federal resources for states to create high-risk pools, reduce out-of-pocket costs or promote better access to services”.
Now, as lawmakers prepare to debate the bill on the Senate floor, many Americans wonder how they will afford the services and treatments necessary for them to maintain their standards of living. To combat these potential pitfalls, disability rights activists have spoken out against the bill, writing editorials and promoting the hashtag #IAmAPreExistingCondition to raise awareness about the potentially adverse effects “Trumpcare” could have on them.
In this episode, The Stream explores the healthcare challenges, costs, and uncertainties of being considered politically a “pre-existing condition”.

Joining The Stream:

Andrew Pulrang @AndrewPulrang
Disability rights advocate

Elsa Sjunneson-Henry @snarkbat
Author and disability activist

Vilissa Thompson @VilissaThompson
Disability rights consultant and writer

Patrice Lee Onwuka @PatricePinkFile
Senior Fellow, Independent Women’s Forum

Lovelyn Anderson
ASL interpreter

Follow our Twitter chat on disability and the US healthcare system with #AHCAchat.