Action Alert! Prevent Gutting of the ACA and Medicaid

February 16, 2017

Congress has already begun the process of repealing the Affordable Care Act (ACA) and it now is on the fast track to include drastic cuts to the Medicaid programs as part of the replacement plan. The result would be two major blows to individuals with disabilities.

People’s health, services, and lives are at stake!  We need advocates to reach out to their Senators and Representatives to let them know why the ACA and Medicaid are essential to people with disabilities and their families.


Take Action:

Call your Senators and Representatives today! Dial the Capitol Switchboard at 202-224-3121 and ask for your Senator or Representative.  Now is the time for ACTION, remember every call matters!  Don’t let them take away health care and services for millions of people and replace it with a plan that CUTS Medicaid.

Attend a local town hall meeting while your Senator or Representative is in district, find scheduled meetings here (thank you to the Town Hall Project for compiling the list).

Call your Governor today, find out how to contact them here. Remind your Governor what cuts to the ACA Medicaid would mean for the state budget and why they matter to you. Share that same message with state legislators.


What to Say:

  • I am your constituent.
  • I am a person with a disability or I am a family member of someone with a disability or I am a professional in the disability field.
  • Do NOT repeal the ACA without a replacement that maintains or improves coverage and protections.
  • Do NOT allow restructuring and cuts to Medicaid to be part of an ACA replacement.
  • The ACA and Medicaid helps me/my family member to have health care and community based services.


Message 1: Do NOT per capita cap Medicaid!

Medicaid is a jointly funded program with matching state and federal funds. Under a Medicaid per capita cap, the federal government would set a limit on how much to reimburse states based on enrollment.  Unlike current law, funding would not be based on the actual cost of providing services. Much like the proposed block grants, the intent of the per capita caps is to restructure the program, cut federal spending and drastically reduce money going to the states. Inevitably there will be cuts in funding and other negative impacts to Medicaid recipients could include:

  • Losing home and community-based services and supports. Waiting lists would quickly grow.
  • Losing other critical services such as personal care, mental health, prescription drugs, and rehabilitative services. If funds become more scarce, states may decide to stop providing these services altogether.
  • Being forced into unnecessary institutionalization. States could return to the days of “warehousing” people with disabilities in institutions.
  • Shifting the costs to individuals or family members to make up for the federal cuts. The costs of providing health care and long term services and supports will not go away, but will be shifted to individuals, parents, states, and providers.

For additional information, see The Arc’s fact sheet about Medicaid.


Message 2: Do not repeal the Affordable Care Act’s protections for people with disabilities!

The ACA is the most significant law for people with disabilities since the Americans with Disabilities Act:

  • Because of the ACA, health insurers can’t deny health insurance if you have a disability or chronic condition.
  • Because of the ACA, there aren’t arbitrary financial limits to how much health care you can get in a year or in your lifetime.
  • Because of the ACA, more people with disabilities receive supports and live in the community, not institutions.

For additional information, see CCD’s fact sheet about the ACA.


Share your story!

The National Council on Independent Living (NCIL) is working to collect stories from the independent living (IL) community that they can use to get Congress to understand how their cuts and changes impact real people around the country.

  • Have you benefited from the Affordable Care Act?
  • Did you gain coverage through Medicaid expansion?
  • Did you transition from a nursing home to your community because of Money Follows the Person?
  • Will your independence be jeopardized by Medicaid cuts?

These are just a few examples of the types of stories NCIL is looking for. Disability allies on the hill say that personal stories are what really make the difference. So please, if you have a story to share, email NCIL’s Policy Analyst, Lindsay Baran, at


The Affordable Care Act

There are key provisions within the Affordable Care Act that support the health and well-being of people with disabilities. To name a few:

  • Health insurers cannot deny someone health insurance on the basis of a pre-existing condition, including a disability or chronic condition;
  • There are no arbitrary financial limits to how much healthcare an individual can receive in a year or in their lifetime;
  • More people with disabilities receive supports to live in the community of their choice rather than in an institution;
  • 20 million adults and children have health insurance through Medicaid expansion and health insurance subsidies;The Money Follows the Person (MFP) demonstration program that helps people with disabilities transition from institutions to the community was reauthorized and expanded;
  • The Community First Choice option (CFCO) was established, which increased the Federal Matching Assistance Percentage (FMAP) for states who provide new or expanded home and community based services (HCBS);
  • The U.S. Access Board was authorized to develop accessibility standards for medical diagnostic equipment (MDE);
  • Millions of adults have been able to stay on their parent’s health insurance plan until age 26; and
  • Health insurers provide more people with the services they need – including mental health services and rehabilitation services and devices.

There are countless other provisions in the ACA that are important to people with disabilities. The ACA has unquestionably improved access to care for people with disabilities and chronic conditions to help them live healthy, independent, and fulfilling lives. Learn more about how people with disabilities benefit from the Affordable Care Act.


Medicaid – Block Grants & Per Capita Caps

Currently the federal government covers a percentage of states’ Medicaid costs. Under Medicaid block grants, the federal government would pay the state a specific lump sum (likely based on historical spending), rather than a percentage of the state’s costs. Under per capita caps, the federal government would pay the state a fixed amount for each beneficiary instead. Both options drastically reduce federal funding for state Medicaid programs, with gaps increasing over time relative to current spending. To counter the significant costs that are shifted to states, they are given ‘flexibility’ to make changes to their program. (National Council on Independent Living)


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This action alert was developed with content from the Long-Term Services and Supports (LTSS) and Health Grassroots Small Group within the Consortium of Citizens with Disabilities (CCD).

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