When I was 17, I tried to kill myself. I don’t remember much, but I remember being taken away from my parents house by the police, and taken to the hospital against my will. In Pennsylvania this is called a 302 commitment. I remember feeling scared at what the future held for me. At the time, I didn’t want to keep on living, I wanted nothing more than to die. While I was admitted to the psychiatric ward at my local hospital, a bigger behind the scenes battle was raging between my parents, their insurance company, and the hospital.
I was hospitalized in February of 2009. This was before the Affordable Care Act. My parents had bought health insurance on the individual market. Back then, there was no mental health parity in the individual insurance market. My parent’s insurance did not cover inpatient mental health treatment. Without any help, my parents would have been facing a hospital bill in the tens of thousands of dollars for my care. In addition to my existing PDD-NOS diagnosis, the on duty psychiatrist diagnosed me with Schizoaffective Disorder, depressive type.
Little did I know that the social workers at the hospital had already been working on my behalf to help my parents apply for Supplemental Security Income. While we waited for a disability determination from the Social Security Administration, I became eligible for presumptive coverage through Medicaid. Medicaid is currently structured as an open ended Federal entitlement. Any disabled person who is approved for SSI is automatically entitled to Medicaid coverage in most states. An even greater provision was that Medicaid gives 90 days worth of retroactive coverage. My entire hospital stay, and the antipsychotic, and antidepressant medications I needed to function were all paid for by Medicaid. If I had not been found when I had, I cannot say I would be alive today. And if it weren’t for Medicaid, I would not have been able to make a full recovery.
As Republicans in Congress begin debating the repeal of the Affordable Care Act, I am scared, and fearful at what the future holds for disabled people like me who depend on Medicaid for our healthcare. Republicans want to end the entitlement aspect of Medicaid, and enact per capita caps on funding. Right now, funding for traditional Medicaid is split between the Federal government, and the states. The Federal government pays on average 57% of the costs while states pay for the other 43%. There are mandatory populations under the law that have to be covered including children, pregnant women, the blind, and disabled, and the poor elderly.
Currently, in the event of an unexpected economic downturn, or healthcare crisis, Medicaid spending can rise as more people become eligible for coverage. In the Republican proposal, a per capita cap would be set for each category (children, blind, and disabled etc.), and states would receive that fixed amount for every beneficiary enrolled. If spending went over that, the state would be responsible for making up the difference. A cap like this would do away with the open ended nature of Medicaid, and in the event of a budget crisis, states would be able to freeze enrollment, enact waiting lists, or even cut people from the program. Governors would be forced to make the hard decisions of who gets to stay, and who gets kicked out. I am worried these caps will hurt disabled people like me.
Right now, I am entitled to coverage as a disabled individual. Per capita caps may very well end that entitlement to Medicaid coverage for disabled people like me. What is also troubling is that the Republican bill ends presumptive eligibility until proof of citizenship is presented, and limits retroactive coverage to the month in which Medicaid is applied for. All of these things would hurt people with disabilities when they apply for Medicaid coverage. I know I am extremely grateful Medicaid was there for me when we had no other source of help to turn too.I oppose the Republican efforts to destroy Medicaid, and enact per capita caps.
As a disabled person I’ve spent the last several weeks writing letters, and making phone calls to my congressman, and senators about why I oppose these Medicaid cuts. Medicaid was there for me, and saved my life, and because there are other people out there with mental illness, or autism, Medicaid needs to remain there for them too. This is why I oppose these cuts. And I hope you do too.