ANCOR Statement on President Trump’s Budget and the AHCA CBO Score
May 25, 2017 – A budget proposal is much more than a financial blueprint – it is a statement of values and priorities. That's why ANCOR is deeply concerned and disappointed that President Trump's first full budget proposal makes dramatic cuts to essential programs that empower people with intellectual and developmental disabilities to live, work and fully participate in their community.
Every day, across this great nation, people without disabilities get up, go to work , go to school, volunteer, raise families, live, laugh and contribute to their communities. Individuals with intellectual and developmental disabilities are no different, but many need a helping hand – or many helping hands – to engage in those activities. They may receive support from a spouse, friend, sibling or parent, but hundreds of thousands of Americans with intellectual and developmental disabilities rely on federally funded programs that include subsidized housing, food stamps, Social Security, and Medicaid-funded private provider services to simply make it through each day. These are lifeline services, and shockingly, each one of them is cut in the President's budget.
Medicaid takes an enormous hit in this budget: up to $1.3 trillion over ten years. Regardless of what it is called in each state, through the Medicaid program, the federal government pays for at least half of what it costs to support individuals in nearly every in-home supports program, supported living arrangement, shared living, adult foster care, transportation, group home, Intermediate Care Facility, respite service, employment support, and day program.
The President's budget cuts Medicaid by building on the $834 billion cut included in the American Health Care Act (AHCA), and adds additional cuts that are achieved by reducing the rate of the federal share within the changed structure of Medicaid to either a per capita cap or block grant. As Office of Management and Budget (OMB) Director Mick Mulvaney explained to press earlier this week, "We assume the Affordable Health Care Act that passed out of the House passes. That has some Medicaid changes into it. We wrap that into our budget proposals. We go another half a step further and ratchet down some of the growth rates that are assumed in the AHCA." This affirms the concern that ANCOR and others have expressed over changing the structural mechanism of funding Medicaid: that with a capitated or block grant structure in place, it becomes easier to simply "dial down" the rate, resulting in reduced funding year over year.
Last night, the Congressional Budget Office released the latest projected costs of the AHCA. The majority of the federal savings achieved by AHCA comes from the Medicaid program by changing the funding structure and cutting the program more drastically than ever before in its history. The cuts will reduce federal Medicaid funding by $834 billion over the next decade. It is a fallacy for Congress and the Administration to assume that services for people with disabilities will be protected at the state level – these cuts will have the result of pitting funding for people with disabilities against other Medicaid beneficiaries, and other important state funding needs such as public safety and K-12 education.
We can never forget that the individuals with disabilities we serve were once warehoused in state-run institutions before Medicaid-funded home and community services were put in place.
As a nation we must do better, and ANCOR urges Congress and the Administration to put AHCA and this budget aside and begin anew. We have made enormous strides from the previous most common methods of “care” and now focus on developing more person-centered supports. If these programs suffer, so suffers the promise of the Americans with Disabilities Act. There could be no worse time than now to interrupt the trajectory of services allowing individuals with intellectual and developmental disabilities to be productive citizens in society.
The dramatic reductions outlined in the President’s budget will result in people with disabilities sitting at home rather than working, living in isolating settings rather than contributing to vibrant communities, being vulnerable to abuse and exploitation rather than appreciating the safety and security we all deserve.
Help us fiercely protect these essential, yet often unseen, services that offer people with disabilities the opportunities to exercise a basic and inalienable right – their American right to independence. Join us June 6th for a cross-disability Hill Day and rally to Save Medicaid.
The American Network of Community Options and Resources is a national trade association representing more than 1,200 private providers of community living and employment supports and services to more than 800,000 individuals with disabilities with a workforce that’s over half a million strong. ANCOR advocates for the crucial role private providers play in enhancing and supporting the lives of people with disabilities and their families.