Mixed feelings about impact of Obama’s health plan on the disabled

As someone with a disability, I should be excited about President Obama’s health plan and motivated to fight for it to become law. But I’m not.

The proposal contains important elements that could improve the lives of many disabled Americans. But the thrust of the overall proposal seems so wrongheaded that passing it as is may do more harm than good in the long run.

The president included potentially significant initiatives designed to make it easier for disabled Americans who need daily assistance to remain in their homes and communities and avoid institutionalization. The Community First Choice option in the president’s plan would offer state governments more money from Medicaid to fund in-home support programs for Medicaid beneficiaries with disabilities who need long-term care.

Funds would also be given to states to extend an ambitious program called the Money Follows the Person Rebalancing Demonstration. Its purpose is to help Medicaid beneficiaries with disabilities who need long-term care “transition from an institutional to a community setting,” according to the Centers for Medicare and Medicaid Services.

There’s also a provision called the Community Living Assistance Services and Supports Act (CLASS Act). It creates a much-needed alternative long-term funding source besides Medicaid. After paying into a pool for a certain number of years through voluntary payroll deductions, working people who become disabled could receive a monthly benefit to help pay for whatever new assistance or equipment they might need.

It would be great if these ideas could become law through legislation not tied to the president’s larger health care financing agenda. The centerpiece of that plan is forcing Americans to purchase health insurance through the predatory private market with no public option as an alternative. In addition, Obama’s plan envisions cutting tens of billions of dollars from Medicare home health services.

So despite the benefits for persons with disabilities, I can’t bring myself to embrace the president’s full proposal. The collateral damage will be too great.

Mike Ervin is a writer and disability activist living in Chicago. He can be reached at pmproj@progressive.org.