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Adapted from an article written by by Ari Ne’eman  Mar 23, 2017. and By Glenn Howatt and Chris Serres Star Tribune staff writers

For the past 50 years, the main goal of disability rights activists has been to help people with disabilities transition out of institutional settings and into their own homes and communities. To accomplish this, advocates and policymakers have worked to establish an extensive system of support services for seniors, non-elderly adults, and children with disabilities; rather than pushing people into segregated settings, the support now comes to them, in their homes.

For Americans with disabilities, the ability to live outside of a nursing home or institution is not just a distinction between two somewhat different kinds of service: It’s a civil rights issue. Institutional life is often regimented, tightly controlled, and very limiting. People living in an institution may be denied basic choices, including when to go to sleep, what to eat, and whom they may talk to (and when).

Thousands of Minnesotans with disabilities could lose medical and personal-care services that allow them to stay in their homes and live independently if Congress passes the GOP health bill (the American Health Care Act) that heads to a crucial vote in the U.S. House today.

The bill is the House Republicans’ vehicle to repeal the 2010 Affordable Care Act, also known as Obamacare, but its biggest impact would fall on the federal-state Medicaid program, which provides health coverage for the poor, elderly and disabled.

The bill cuts $880 billion in federal funds to the states over 10 years and could reduce enrollment by 24 million people by 2026, according to a recent Congressional Budget Office (CBO) estimate.

Under current law, each state receives a federal match that covers a set percentage of the state’s Medicaid costs, a figure calculated based on the state’s poverty levels relative to the rest of the country. This means that states are reimbursed based on their actual Medicaid costs, which allows them to experiment by investing in new types of services or respond quickly to changing demographics or public health emergencies.  In Minnesota, that would mean a $2 billion shortfall shortly after the cuts commence in 2020, with the impact falling disproportionately on people with disabilities and low-income seniors, according to a state analysis released this week.

The AHCA’s Medicaid cuts put people with disabilities at profound risk, threatening to turn the clock back decades to a time when in-home care was rare. For people with disabilities, such a step back threatens lives — as well as the most basic of freedoms.

(image description: PCA Nora Clark attends to Scott Semo who is sitting in a recliner chair in his home.  In the background are windows that show trees and snow. There are also three balloons that are attached to Scott’s bed and floating in the air)

American Health Care Act

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