Kingia Randall with her sister Valarie White, who struggles with severe arthritis, schizophrenia, bipolar disorder and other health issues. White relies on Georgia Medicaid’s family caregiver homecare services provided by Randall five days per week. (Jess Mador/WABE)
At her small, subsidized apartment west of downtown Atlanta, Valarie White rests on the couch. Her arthritis makes it difficult for her to do the things she used to do for herself. The 60-year old says she’d be lost without her sister’s help at home.
“Because now, with this arthritis, it’s hard to open up my medicine bottles. She fixes my medicines up for me because my hand is not working right right now,” White says. “This arthritis is killing me so bad.”
White also has schizophrenia and bipolar disorder.
“And my memory ain’t that long,” White says, adding that she is grateful her sister keeps track of her many health appointments and medication schedule.
“If I’m having problems, I say, do you know, did I take my medicine today?” White says.
Her disabilities and low, fixed income qualify White, who also receives Medicare, for Georgia Medicaid’s homecare services, and a paid, trained family caregiver through Georgia’s community based waiver program for elderly people and people with disabilities.
“I saw the need because my sister was always getting different people all the time,” says Kingia Randall, White’s younger sister.
Randall was already a professional homecare worker, a job she has done for more than two decades with other seniors and people with disabilities in Georgia.
She recently got certified to become White’s official caregiver.
“Nobody was staying. So, I was like, I’ll fix that. I’ll apply for a job and I’ll become her caretaker,” Randall says. “That’s when I got hired through an agency to do the work for her.”
Her Medicaid-certified agency pays Randall $11 per hour before taxes to care for her sister six hours per day, five days a week.
The list of daily activities Randall helps her sister with is long.
“It’s just her daily get up and go things, her constant reminders to take her meds. Little everyday common things that we do that she doesn’t remember to do a lot of times,” Randall says.
“I make sure she brushes her teeth, washes her face, make sure she picks up behind herself, help her cook. Sometimes I go out and buy her food, just depending on what she needs,” she says. “We walk at the park because she has to be more mobile. The doctors are trying to make her more mobile because she has to have surgery, so she has to lose a little more weight.”
Now, Randall worries what would happen to her sister as House Republicans have proposed sweeping cuts to federal Medicaid funding and other major changes to the safety net program as part of the Trump administration’s tax breaks and spending cuts.
Health advocates in Georgia are worried, too. Medicaid covers about two million low-income adults and children in Georgia. Nearly 40% have a disability.
And hundreds of thousands of people with Medicaid in Georgia rely on daily assistance with their personal basic needs, including cooking, housekeeping, bathing and dressing.
Disability advocates and people who use caregiving services fear the proposed federal cuts would upend their care.
Congressional Republicans promise the changes to Medicaid would target “waste, fraud and abuse” in the program. But not essential coverage.
“These kinds of cost-shift proposals are particularly attractive to Congressional policymakers because they can misleadingly claim that they are not directly cutting eligibility or benefits, even though states are left holding the bag with these cost shifts, and the costs are so large, the magnitude is so great, that damaging cuts to Medicaid will be the inevitable result of such proposals if they were enacted,” says Georgetown University Research Professor Edwin Park, who specializes in Medicaid and health care policy.
Park says federal cuts to the jointly funded state-and-federal program would force states to make difficult choices.
“Either raise taxes dramatically, cut other parts of their budgets, and that’s primarily going to be education, or cutting Medicaid,” Park says. “And that means likely taking away coverage and access from tens of millions of low-income kids, parents, seniors, people with disabilities who are on the program today.”
“If Medicaid ends, how am I going to pay for my meds? How am I going to get to the doctor? How am I going to do this? I see a lot of specialists, How am I going to pay for my doctor visits? If all that’s out, I’d be lost and it’s stressful.”
Valarie White, 60
A preliminary estimate from the independent, nonpartisan Congressional Budget Office found the proposed House Medicaid changes, that include new work and verification requirements, would shrink the deficit by hundreds of billions of dollars over a decade, while increasing the number of uninsured Americans by at least 7.6 million by 2034, according to nonpartisan health news and policy organization KFF.
Disability advocates in Georgia are among the groups pushing to prevent federal Medicaid funding cuts.
They are also pressing for state officials to come up with a mitigation plan to minimize harm to vulnerable Medicaid recipients if federal cuts are enacted this year, as well as protections for Georgia workers who provide at-home caregiving services paid for by Medicaid.
“We’re trying to look at our local government here, which has a couple of billion dollars in surplus, to say how we are going to support these two million Georgians that may lose their coverage if Medicaid is cut by the federal government,” says Stephen Murray, organizing director for the Georgia chapter of We Dream in Black, part of the National Domestic Workers Alliance.
Kingia Randall tidying up the kitchen for her older sister Valarie White, who struggles with severe arthritis, schizophrenia, and bipolar disorder, and other health issues.
White, who also gets Medicare, relies on Georgia Medicaid’s family caregiver home care services. (Jess Mador/WABE)
At her sister’s apartment, Randall is tidying up the kitchen and washing some dishes. She and White say they’re following the news about potential cuts to Medicaid.
But, White says thinking about what could happen to her Medicaid makes her anxious.
Her Medicaid gives her peace of mind. She needs the daily home care services, she says.
And without the coverage, her medications would cost more than her monthly rent.
“If Medicaid ends, how am I going to pay for my meds? How am I going to get to the doctor? How am I going to do this? I see a lot of specialists,” White says. “How am I going to pay for my doctor visits? If all that’s out, I’d be lost and it’s stressful.”
White says she particularly dreads potentially losing access to her psychiatric medications and experiencing what she calls ‘episodes’ again.
She recalls a time some years back when she ended up hospitalized for mental health crisis stabilization care.
“I just couldn’t really hold onto a job at that time because I was having so many episodes at work, and you know depression came in and all that other stuff,” she says. “I was going to give up on life. I really was.”
Randall says she also knows her sister won’t remain stable for long without her bipolar and schizophrenia treatment, like, Randall says, “meds that help keep her life moving forward to where she’s not a danger to herself or to other people.”
“It wouldn’t be great at all. Some people commit suicide because of her illnesses. That would be devastating,” she adds.
The sisters say they hope this message reaches Congressional lawmakers before they slash the program that covers more than 72 million low-income adults and children nationwide.
