Dear Chairman Hatch, Senator Wyden, and Members of the Senate Finance Committee,
The Center for Disability Rights (CDR) is a disability led, not-for-profit organization headquartered in Rochester, New York. CDR advocates for the full integration, independence, and civil rights of people with disabilities. CDR provides services to people with disabilities and seniors within the framework of an Independent Living Model, which promotes independence of people with all types of disabilities, enabling choice in living setting, full access to the community, and control of their life. CDR works for national, state, and local systemic change to advance the rights of people with disabilities by supporting direct action, coalition building, community organizing, policy analysis, litigation, training for advocates, and community education.
I write to express CDR’s deep-seated and unequivocal opposition to the Graham-Cassidy Amendment, which is being heard in your committee today. That opposition is shared by virtually the entire Disability Community, many members of which have visited our offices multiple times over the summer, in some cases literally begging for Congress not to end our lives by cutting the services we rely on.
This bill is the latest and possibly the worst in a series of proposals to cut off Medicaid funding that supports the independence, integration, and civil rights of disabled people and seniors. These proposals have been advanced, perhaps cynically, under the cover of repealing the Affordable Care Act, a longstanding Republican commitment, but along the way to achieving that aim, the Graham-Cassidy Amendment will visit untold misery upon millions of Americans who only wish to participate as equal citizens in the promise of America.
Millions of Americans with disabilities and seniors rely on home and community based services to live and participate in this great country. These services enable us to work; to participate in the social and cultural life of our communities; to raise our families; to go to school, both as students and as teachers; and even to participate in this great democratic republic by attending campaign events and voting in elections. We are able to do these things because of home and community based services.
Medicaid is the largest single provider of home and community based services, but under Medicaid law these services are optional, meaning that states are not obligated to provide them but may do so. By contrast, states are obligated to provide services in institutional settings. This is called the “Institutional Bias” in Medicaid, and it is a priority of many disability rights organizations, such as ADAPT and the National Council on Independent Living, and many senior rights organizations, such as AARP, to reverse the institutional bias and ensure that home and community based services are available on at least an equal basis as services in an institutional setting.
Why is this relevant to the Graham-Cassidy Amendment? Because institutional services are mandatory, which means that, under the Medicaid cuts proposed in this bill, states will continue to be obligated to provide services in an institutional setting. Home and community based services are optional in many states, which means that those services, the ones which support the independence and integration of disabled people, will be cut first because they can be cut.
When home and community based services are cut, disabled people and seniors will be forced into expensive institutional settings, which will themselves be underfunded in turn, and made even more into squalid hives of abuse and misery than they already are. Many disabled people have worked hard to escape these institutions and to live independently in the community, as equal citizens and equal participants in the American dream. This bill strips all of that away. In a stroke it erases decades of disabled people carving out places for ourselves, piece by piece, by petition and protest and the indomitable human spirit.
CDR opposes this bill because, if it is passed into law, it will assuredly strip away the equality, the liberty, and ultimately the lives of disabled Americans and seniors. We oppose this bill because it is unworthy of the promises of this great country.
We urge you and all members of the Senate Finance Committee to vote against this bill, to publicly call on your colleagues to oppose this bill and the needless human misery that will result in cutting the services that disabled Americans and seniors rely on.
Adam Prizio, Esq.
Manager of Government Affairs
Center for Disability Rights, Inc.