July 5, 2017

In a letter hand-delivered to all 100 United States Senators today, the National Down Syndrome Society, the leading human rights organization for all individuals with Down syndrome, reiterated its strong opposition to the Senate “Better Care Reconciliation Act (BCRA) of 2017”. The Senate bill outlines a new Medicaid financing mechanism – per capita spending caps and block grants, which NDSS also opposed in the U.S. House of Representatives bill, as it would be detrimental to individuals with Down syndrome and their families.

People with Down syndrome already struggle to obtain healthcare and supportive services they need and deserve. Under the Senate legislation, states would face even larger funding deficits in their Medicaid programs, leading to potentially significant cuts in cost-effective health insurance and supportive services for people with disabilities.

“We continue to urge Senators to protect the most vulnerable in our society and oppose any legislation, including the BCRA, that cuts Medicaid spending for people with disabilities,” NDSS President Sara Hart Weir said.  “Enactment of the Medicaid per capita reimbursement caps in the Senate bill would reduce access to medical assistance and services and halt the progress that has been made in promoting home and community-based services.”

In addition to capping medical assistance expenditures made on behalf of adults with disabilities, the Senate bill would lead to steep cuts in programs critically important to people with Down syndrome – such as employment supports through Long-Term Services and Supports (LTSS), and Section 1915(c) Home and Community-Based Services (HCBS) – which are optional services that states are not mandated to provide.

The Medicaid and CHIP Payment and Access Commission recently submitted a report to Congress that shows that only slightly more than 47 percent of all Medicaid spending is for mandatory services to mandatory populations. People with Down syndrome receive employment supports from Medicaid that enable them to both attain and maintain gainful employment. Individuals with Down syndrome also receive Home and Community-Based Services that allow them to be active and valued members of communities. Employment supports and HCBS are optional services and would likely be the first services to be cut by reimbursement caps.

“We need more cost-effective health insurance options and supportive services to be made available to all individuals with Down syndrome and other disabilities,” Weir said. “With Medicaid funding cuts, the Senate’s BCRA will take a sharp turn in the wrong direction, and we are urging every Senator to vote against BCRA.”


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