Dear Kellyanne Conway,
I was dismayed to learn of your recent comments stating that people who receive Medicaid and would lose it under the Republicans’ proposed health care plan can just “get a job” that provides health insurance. Your words are misleading and inaccurate. You see, I and millions of others who would lose healthcare do have jobs. But Medicaid is the only option to get the help we need.
You talk about disabled people and people who can work as if the two groups are mutually exclusive. They are not. I’m disabled, I have a Master’s degree and I work about 30 hours a week. One in five people with disabilities have jobs. Many more want to work but can’t find employment due to discrimination, or they fear losing benefits if they make too much money to qualify but not enough to cover their bills.
You talk about Medicaid as if getting insurance some other way would provide the same benefits. It doesn’t. I have insurance through my father’s former employer, and have been covered under it since I was a baby. I’m allowed to stay on it as an adult because of my disability. So why am I on Medicaid? Because I have cerebral palsy and use a power wheelchair. I can’t get out of bed, use the bathroom or dress myself without a personal care attendant. And here is something you and most other politicians probably don’t know… No private insurance pays for that. I have private insurance! But I have no choice but to also be on Medicaid, because I need a Medicaid waiver to pay for my caregivers.
The Republican Party’s healthcare plan would cut over $700 billion from Medicaid and cap the amount states can receive per beneficiary. This will almost certainly lead to cuts not for “able-bodied” people, but for people like me whose care is costly because of our disabilities. Without my Medicaid waiver, my care would cost $4000/month out of pocket, which I can’t afford. Not many people could! As for seeking other funding, few charities or churches could absorb that kind of expense for one person, let alone en masse. And while I think most people would agree home care is essential, I’m not sure how many would donate to a “Help Karin Pee” GoFundMe. In a country with so much wealth, in a society that values hard work and caring for each other, people with disabilities should not have to beg to get our basic needs met.
Oh, and about those cuts for able-bodied people — there’s something else you should know. My state’s Medicaid waiver home care program pays only $9.35 per hour to the people who come into my home every day to help me get out of bed, use the bathroom and shower. Despite doing this physically strenuous work for a McDonald’s wage, they are not eligible for health benefits through the program, and their hours are capped at 40 per week. Currently most of my personal care attendants have Medicaid, but they would lose it if this bill passes, because they’re able-bodied. They would have no access to health care if they get injured while lifting me, no medication to keep them from missing work if they get sick. And with such a low wage, they wouldn’t be able to buy a health plan on the exchange. So your suggestion that they get a “better job” with benefits would require that they stop working for me, leaving me without care.
In my opinion, this so-called health reform is all about taking from millions of poor and working people to give to the rich — the few who would see $4000 per month for home care as pocket change. And that “22 million will lose healthcare” statistic doesn’t tell the whole story. Disabled beneficiaries are not counted in that number because technically, we wouldn’t lose Medicaid. We’d still have coverage to see a doctor or have surgery. But without funding, Medicaid waivers (which are considered “optional” for states to offer) would be eliminated or scaled back, leaving us without the part of Medicaid many of us need most — our home care.
I know you and other Republicans are concerned about lazy people getting free money and stuff from the government. Are there a few losers out there cheating the system? Of course. I’ve met them, you’ve met them. I’ve fired several of them who thought being a personal care attendant would be a good job for slackers or an easy way to steal from an employer. I don’t believe my fellow liberals do ourselves any favors by denying they exist. But they are a tiny number of people, a small percentage of the millions who will suffer if this bill passes. And focusing on them only stigmatizes people with disabilities by painting us all with the same broad brush.
If you actually want to fix the system, there are so many ways to do it without hurting anyone. I personally favor single-payer healthcare for all, but as a Republican, you probably hate that idea. So here are some you might like, or at least hate less.
First of all, require private health insurance to do more for people like me. I know you think you’ll save money by cutting essential benefits, but adding home and community-based services to the things insurance must cover would actually save the government money, because fewer people would apply for disability. Many of us need disability benefits and/or Medicaid just for personal care attendant funding, and some of us even have to limit our income and/or resources because of Medicaid’s strict limits. Without these restrictions on our income, those of us with private insurance would be more free to get better jobs, invest in the stock market, receive financial assistance from grants, loans and loved ones, and generally improve our lives.
Second, cut Medicaid funding for nursing homes. Now before you brand me as a monster who wants to put Grandma out on the street, I’m not suggesting we take away funds from elderly people currently in nursing facilities. However, over time we can give nearly all new Medicaid beneficiaries who need assistance with activities of daily living home and community-based services instead of institutional care. This is the humane thing to do — most people don’t want to live in a nursing home, after all — and it also saves money. It’s cheaper for the government to pay for me to get care in my own home where I work and pay for my own food and other expenses than to put me in a nursing home, and on average that’s true for all people with disabilities and seniors.
Third, increase funding for home and community-based services beyond what is redirected from nursing home care. People often ask why the United States healthcare system costs so much compared to other countries. While there are many reasons, one is because we don’t value prevention of illness and helping people maintain health. We don’t seem to understand that if we spend a bit of money now, we can save a lot later. Currently hundreds of thousands of people are stuck on waiting lists to get home and community-based services. Those who do get services often don’t get enough hours of care to truly meet their needs, and they have difficulty finding skilled and reliable attendants due to the low pay. We should not be giving a fast food wage to those we trust to care for people with disabilities and the elderly. By increasing home health workers’ pay and providing adequate hours of care to those who need it, home care can reduce infections, falls, hospitalizations and other negative health outcomes.
People with disabilities have more opportunities to work, spend time with family and be part of our communities when we live in our own homes. We can and do contribute to society when we are valued as human beings. Right now I am terrified that Medicaid will be cut and I will lose my independence and ability to live in my own home. As an American citizen, I have the right to life, liberty, and the pursuit of happiness. Don’t take it away!
146 , 1