House Republicans in Washington are planning to vote Thursday on a bill to replace the Affordable Health Care Act, also known as Obamacare. Pre-existing conditions have ruled the headlines this week, but the bill still includes big changes to Medicaid.
Potential cuts to the Medicaid program have worried people with disabilities and advocates in Georgia, including 38-year-old Evan Nodvin.
Nodvin, who has Down syndrome, shares a two-bedroom apartment in Sandy Springs with a roommate. He goes to work five days a week at a community fitness center in Dunwoody, helping out people who come to work out.
“I give out towels, and put weights away, and make sure people are safe,” he said.
To get to and from work, Nodvin gets rides from people who are hired to help him. After he gets home from work, Nodvin works with a counselor to do daily chores like grocery shop, clean, cook.
“My favorite thing to cook on Wednesdays — I like to cook turkey patties once a week,” he said. “And on Thursdays I make fish, and other days, I make other good stuff like spaghetti.”
Nodvin can live independently because of these services, like transportation and counseling — services that are covered under a Medicaid waiver program for people with developmental disabilities. So when Congress started to talk about making big changes to Medicaid in the healthcare bill in March, Nodvin went to D.C. with a group of advocates to lobby.
He read a speech there, which he recites in his living room.
“As you can see, my life is very full. I work, live and play in the community. My dream is to continue this healthy and useful life. Thank you,” he reads.
‘Fairly Severe’ Impact
But that dream is uncertain. The Congressional Budget Office had estimated the proposed cuts to Medicaid in the original bill would have amounted to $880 billion dollars over 10 years. In Georgia, more than half of the state’s Medicaid dollars go to the elderly or people with disabilities, according to the Georgia Department of Community Health.
Instead of matching state funds, under the new plan, the federal government would give states a fixed amount of money based on what they’ve been spending, said Bill Custer, a professor of health administration at Georgia State University.
“In a state like Georgia, the impact would be immediate and fairly severe over time,” he said
According to the Kaiser Family Foundation, Georgia ranked 48th in Medicaid spending per enrollee. Georgia currently gets about two federal dollars for every one dollar the state puts in, but the new plan would give states a capped amount of funding for Medicaid.
Custer said Georgia’s Medicaid program might be okay in the beginning, but as healthcare costs rise, states will increasingly have to shoulder the burden.
“That means states are going to have to either find the money to maintain the program or shrink the program either by covering fewer services, or covering fewer people, or both.”
‘Jail For No Crime’
That worries Eric Jacobson, executive director of the Georgia Council on Developmental Disabilities, a state advocacy group.
“Medicaid is the lifeline for people with disabilities,” he said.
Jacobson said the community support services like Nodvin gets under Medicaid are considered optional by states.
“Those are the kinds of services that we hope won’t get cut, but because of the reduction in funds might be the first on the chopping block,” he said.
He said services are already limited. According to the state Department of Community Health, nearly 9,000 people with disabilities are on a waiting list to get help in order to live on their own or in their communities.
Jacobson worries if those services are cut, more people would be forced into institutions.
“The way I look at it of institutionalization for people with developmental disabilities – It’s kind of like sending you to jail for no crime,” he said. “You can’t go out. I remember talking to somebody and he said ‘I want to take my girlfriend to the movies. I can’t take my girlfriend to the movies because I’m not allowed to go off campus.’”
In his Sandy Springs apartment, Evan Nodvin tabs through his CD collection. He has a Beatles poster hanging up near his room, and CD’s.
“I have Michael Jackson, Beatles, whatever… I got more of them here,” he said.
He’s lived on his own for the last 16 years, not long after graduating high school. He has a job, a girlfriend, an apartment, like he said in his speech in D.C.
“I am able to be independent because I help from my Medicaid waiver in my state of Georgia,” he said.
That’s why Nodvin and his family will be watching what happens next in Washington D.C.