States need to halt Medicaid cuts

States must halt their assaults on the elderly and people with disabilities.

Facing an economic crunch, more than half the states in the country have opted for cruelty. They are slashing crucial services, such as providing meals or paying for home health care or housecleaning for those who need assistance.

These services help the elderly and people with disabilities like me function in our homes and our communities.

But state governments are given a perverse incentive by the federal government to pursue this destructive course. Medicaid rules require states to pay the cost of keeping someone receiving Medicaid in a nursing home, while states can refuse to pay for home and community supports.

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Ironically, this may end up costing states more in the long run.

The Deloitte Center for Health Solutions recently published a study entitled “Medicaid Long-Term Care: The Ticking Time Bomb.” It shows that if the current trend of long-term care expenditures continues, more than 35 percent of states’ budgets will be dedicated to Medicaid by 2030. Half of that spending will be on long-term care.

This report concludes that cuts by states in home and community services “will further aggravate state Medicaid performance since in-home/community programs are less expensive to provide and often reduce the need for institutional care.”

The Center on Budget and Policy Priorities details how savage these cuts are.

Tennessee, for instance, “has reduced community-based services for people with intellectual disabilities and cut nursing services for some adults with serious disabilities,” the research group says.

Florida “has cut Medicaid reimbursements to hospitals and community-based services for the elderly, such as meals and homemaker services,” the center notes.

And Georgia has reduced services for people with Alzheimer’s.

Millions of elderly and people with disabilities, like me, rely on publicly funded assistance to live productively in our homes and communities.

Those of us who rely on these services don’t want to be punished by being segregated away into nursing homes.

It makes sense economically and in every other way for us to be among our families and friends.

Mike Ervin is a Chicago-based writer and a disability-rights activist with ADAPT ( He can be reached at

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