Medicaid reforms need not undermine services

Rabbi David Saperstein

By David Saperstein and William Daroff, JTA

WASHINGTON—During February, Jewish communities across North America observe Jewish Disability Awareness Month. It is an opportunity for us to raise awareness of the needs, strengths, opportunities and challenges of individuals with disabilities in our communities, and to ensure we are building more inclusive communities that celebrate all of our neighbors.

The Jewish community, through its institutions and social service agencies, has been increasingly effective in serving the critical needs of individuals with disabilities and their families. At the same time, we recognize the indispensible impact that Medicaid has on the ability to provide for these needs.

For many members of our communities with disabilities seeking healthy, independent lives, Medicaid is an essential resource. Earlier this month, Jewish leaders from across America came to Washington to express to Congress how vitally important Medicaid is to the disability community, as well as the agencies and communities that serve them.

More than 8 million individuals with disabilities in America rely on Medicaid as their sole source of comprehensive health and long-term care coverage. Medicaid ensures that people with disabled have access to essential services, including transportation, medical care and personal care assistance. This, in turn, ensures that they are able to contribute economically, socially, politically and spiritually to their communities.

Unfortunately, under several prominent congressional proposals being considered as part of deficit reduction efforts, Medicaid would be restructured by capping funds flowing to states and/or creating a block grant formula. Block granting or capping Medicaid funds would result in the denial of health and long-term care to millions of Americans, including those with disabilities. These kinds of spending cuts and harmful changes to Medicaid would undermine human dignity by limiting the choices and opportunities for people with disabilities.

Terry Burke and Andy Berman of St. Louis Park, Minn., say that Medicaid has truly been “the saving grace in their family.” Their 23-year old daughter, Rachel, who has cerebral palsy, epilepsy, autism and moderate cognitive disability, is the joy of their lives, but things have not always been easy.

When Andy was diagnosed with chronic lymphocytic leukemia, he and Terry quickly learned that juggling the demands of health care for Andy and care for Rachel was extremely challenging. Through Medicaid, Rachel is able to have personal care assistants, or PCAs, help her with basic needs, ranging from showers and meals to helping her with visits to the doctor. She also has the opportunity to participate in programs that truly contribute to her happiness and “allow her to really have a life,” such as recreational social nights, exercise programs and making dinner with her PCAs.

As Terry and Andy grow older, as they balance managing the health needs of Andy and Rachel, and their ability to manage Rachel’s care declines, they cannot imagine a future without the services provided through Medicaid.

Leading Jewish organizations have made it a priority to fight to protect the services and benefits that individuals with disabilities and their families receive under the Medicaid program. We as a community believe that while there is still a need to reform the program to ensure it remains sustainable through a time of austerity, the program provides services to individuals with disabilities and their families that must remain intact.

Collectively, the Jewish community sees a number of effective ways that Medicaid can be reformed while realizing cost savings. These proposed recommendations range from allowing funding for home- and community-based services (services that cost less than comparable institutionalized care) to be accessed without the current burdensome waiver process, to promoting preventative measures such as chronic disease management.

Other recommendations include enrolling beneficiaries in drug and care management programs, which ultimately would improve the delivery of services and generate savings.

Any reforms to Medicaid to make it financially sustainable for future generations must be made with the mind-set that Medicaid remains available as a source of health and long-term services for individuals with disabilities and other low-income populations.

Jewish organizations and social service agencies across America stand ready to work with our federal and state governments to ensure that individuals with disabilities are able to live healthy, independent lives. We all have a role to play in ensuring this end, and Medicaid is an essential tool in that effort.