March 10, 2017

Early this morning, the House Ways and Means committee approved the American Health Care Act (AHCA) which repeals portions of the Affordable Care Act. AHCA is harmful to millions of Americans with disabilities, and particularly harmful to New Yorkers with disabilities, as well as to the financial health of New York State.

Every American has the right to liberty. Your disabled constituents, however, cannot exercise that right – the right to live where we choose, go where we choose, worship where we choose, befriend whom we choose – without community based services to support our lives. Without these services, disabled people will die or be forced into costly institutions and other facilities. Although community based services are generally cheaper than forced institutionalization, the longstanding institutional bias in Medicaid has restricted access to community-based services, in so doing, depriving disabled Americans of liberty. The AHCA repeal of the ACA undoes Medicaid reforms which have been vital in overturning that institutional bias. The AHCA repeal, therefore, strips people with disabilities of this right by taking away our ability to live in the community, and instead, forcing disabled people into costly nursing facilities and other institutions.

For example, AHCA proposes to end the Community First Choice Option (CFC), a Medicaid state plan option that incentivizes providing home and community based services to individuals with disabilities who would otherwise be forced into an institution to receive services and supports. States that adopt CFC receive a 6% increase in Federal Medical Assistance Percentage (FMAP) for the CFC services that the state provides.  Eight states, including New York, have already adopted CFC and other states are in the process of doing so.

CFC has already brought hundreds of millions of dollars into New York State, and is projected to continue to bring over two hundred million per year. If CFC is killed in the ACA repeal, New Yorkers with disabilities will continue to have the same service needs, but New York will not be receiving the funding through CFC to meet those needs. That means the cost of services and supports for disabled people will fall onto New York State.

For another example, the per-capita Medicaid cap will force States to deny services to disabled people and seniors right off the bad, and will fail to keep up with the needs of our aging population. The per-capita Medicaid cap imposes cuts which will visit untold suffering on many New Yorkers and many more Americans.

Americans did not elect our Representatives to cut services to people with disabilities and strip away our liberties. New Yorkers did not elect our Congressional Representatives to harm New Yorkers by repealing CFC, cutting services to disabled New Yorkers and costing all New York taxpayers hundreds of millions of dollars. Disabled New Yorkers and seniors overwhelmingly prefer living and receiving services in the community over being forced into an institution. CFC is a win-win program for New York: it allows the State to meet the preferences of its Disability Community and seniors, while at the same time creating savings and drawing in Federal funding. Repealing CFCO is a lose-lose for New York: it costs the State more money, and more New Yorkers will be institutionalized against their will.

We call on our New York Congress members, and specifically the Republicans, to stop going down this path which will harm disabled New Yorkers and the State of New York.