ASAN is alarmed by the House’s passage of the Limit, Save, Grow Act yesterday, on April 26th. This bill would impose budget cuts and work requirements to Medicaid. Medicaid is an essential program that provides healthcare to 85 million Americans. Many beneficiaries are people with disabilities. If passed into law, this bill would require “able-bodied people” to work at least 80 hours per month or risk losing coverage. ASAN continues to oppose any work requirements for Medicaid, as we did in 2018. Despite what proponents claim, these changes would disproportionately harm people with disabilities.
The Limit, Save, Grow Act would result in people with disabilities losing their health care and supports. Many people who qualify for Medicaid because of poverty or reasons other than disability still have disabilities that come with barriers to work. Research shows that people on Medicaid are already working full- or part-time if they can. Most of those who aren't working either can't find work, aren’t working due to a disability or illness, or have caregiving responsibilities that keep them out of work. This bill jeopardizes the health and safety of people who will lose access to Medicaid and imposes cruel requirements that do not take into account the lived realities of Americans.
Even for Medicaid recipients who meet the bill’s definition of “physically or mentally unfit for employment,” the bill imposes the burden of filling out complex paperwork to prove they are exempt from the requirements. Increasing barriers to services by adding additional documentation and forms for recipients to manage will add particular strain to people with disabilities. Many people who meet these burdensome requirements would still lose their services due to not being able to complete this paperwork – especially people whose disabilities impact cognition and executive function, like autism does.
Additionally, many people who provide support to disabled people would lose their health coverage under this bill, which further harms disabled people. Some are providing support unpaid and wouldn't be considered to be "working" under the plan, while others who are working poverty wages to provide direct support would lose coverage because they're unable to keep up with the administrative burdens that accompany work requirements.
We can also predict that this bill would cause states to reduce the amount of funding they provide for home- and community-based services (HCBS). It’s already optional for states to cover HCBS, and so when the federal government imposes new funding caps on Medicaid, these services are often among the first things states cut. This bill leaves the 7 million people who rely on HCBS funding at risk. This will be disastrous for people with developmental and intellectual disabilities, since Medicaid HCBS already doesn't provide services to everyone who qualifies, and many states have long waiting lists. Without the ability to receive services in the community, many people with disabilities will instead be forced into institutions.
ASAN is glad to see that President Biden has vowed to veto the bill, making it unlikely that the bill will become law. However, the entire disability community must work to protect and preserve Medicaid and other programs that provide important services to people with disabilities throughout the budget process. We demand no cuts, no funding caps, and no work requirements for Medicaid. Any cuts or restrictions to Medicaid will disproportionately impact people with disabilities and our families, compounding the strains disabled communities face in meeting our daily needs.
The Autistic Self Advocacy Network seeks to advance the principles of the disability rights movement with regard to autism. ASAN believes that the goal of autism advocacy should be a world in which autistic people enjoy equal access, rights, and opportunities. We work to empower autistic people across the world to take control of our own lives and the future of our common community, and seek to organize the autistic community to ensure our voices are heard in the national conversation about us. Nothing About Us, Without Us!
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B. Buil is an endorsed Chaplain, DEI Educator, Somatic/Trauma Care Practitioner, Disability Rights Advocate, Environmental and Social Justice Activist