The NYS budget gives millions away to nursing facilities at the expense of disabled people’s freedom.

Last spring, you might have seen me and about sixty other people from the disability rights group ADAPT being pulled from our wheelchairs and dragged away by Capitol Police outside of Mitch McConnell’s office. Or maybe you remember disabled people protesting against the ACA repeal at the offices of U.S. Senators all last summer. Members of ADAPT were thrown out of the offices of Senators Marco Rubio in Orlando, FL, and Rob Portman in Columbus, OH. ADAPT took over Senator Gardner’s office in Denver, CO for three days. 

What we chanted, every time, was “No cuts to Medicaid. Save our liberty!” For disabled people like me, home and community-based services — paid for, in large part, by Medicaid — are what secure our freedom to live as equal citizens. Medicaid is the primary payer for community-based long-term services and supports in the United States, which assist disabled people who are just like me to live in the community rather than being institutionalized in a nursing facility, by providing assistance with tasks such as eating, dressing, showering, cooking, medication management, and housework.

The significant Medicaid caps and cuts that were proposed by members of Congress last year would have fallen on these community-based services first, even though they’re cheaper than nursing facilities — because these services, unlike institutionalization, are optional under Federal law. That is why we chanted “No cuts to Medicaid! Save our liberty!”

New York’s new Budget, passed with the consent of Governor Cuomo and both houses of the legislature, makes radical changes to the Medicaid system that jeopardize that liberty in order to give a ton of taxpayer money to nursing facilities. In New York, most people on Medicaid get services through Managed Care plans — basically insurance companies. The budget has the State shouldering the cost of nursing homes for people who are “permanently placed” in them for more than three months. This means that insurance companies can save money by pushing disabled people into nursing homes at the expense of the State.

This is bad for disabled New Yorkers in exactly the same way as the Medicaid cuts proposed by Republicans in Washington. It will mean a loss of freedom for disabled and elderly Americans. Our Governor, who seems very quick to point out the areas where his administration differs from the Trump Administration, is doing the President’s dirty work when it comes to elderly and disabled New Yorkers. ADAPT’s work in D.C. saved New York hundreds of millions of dollars that the state would have lost if the ACA had been repealed, and for our trouble, Governor Cuomo is incentivizing managed care plans to lock us away in institutions.

This Budget is especially troubling because, under Governor Cuomo, wages for home care workers upstate have, at best, held steady and in many cases even declined under the Medicaid redesign. ADAPT and many other organizations have called on the State to improve the wages of home care workers, and the situation has only become more and more dire. The Governor’s lack of action on this issue has made it difficult, especially upstate, for disabled people to live in the community. Rather than solve that problem, this budget offers a powerful financial incentive for managed care plans to institutionalize disabled people and seniors.

I spent a year of my life fighting Congress in Washington to prevent disabled people being forced into institutions, only to find that I am being forced to have this same fight with my own Governor and Legislature. We have spent the last three months explaining to them how damaging this policy would be if they implemented it after six months in the facility. It is as if they listened to us and thought “how can we make it worse?” They have refused to engage the Disability Community on these issues and have implemented a budget that strips disabled and elderly New Yorkers of life and liberty – just like Donald Trump. Unlike with Trump and the Congressmen who had us arrested, when Governor Cuomo and the legislators lock us up, we won’t be getting our day in court.

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