Medicaid Buy-In Program at Risk: Coloradans with Disabilities Fear Impact of Proposed Cuts

Introduction

Curt Wolff, a 55-year-old resident of Thornton, Colorado, is grappling with the profound effects of living with paralysis due to West Nile Virus. A former handyman franchise owner, Wolff recalls the moment his life changed dramatically after a mosquito bite led to complications he never anticipated. “We didn’t even realize this was a side effect that could happen,” Wolff stated during a recent interview at his home. Despite his physical limitations, he has managed to maintain a semblance of independence and is particularly concerned about the potential impacts of looming Medicaid budget cuts.

Living with Disability

Following the mosquito bite, Wolff became paralyzed, relying on a wheelchair and a dedicated team of home care professionals for essential daily activities. Covered by Medicaid, these services enable him to transition from bed, dress, bathe, and partake in other fundamental self-care tasks. "Seven days a week," he explained, "someone gets me out of bed, gets me dressed, feeds me breakfast, all the way to shaving me."

Despite the challenges of his condition, Wolff remains optimistic. He describes himself as "pretty dang healthy," and emphasizes his ability to advocate for others in the community through his business, which manufactures parts for a wheelchair bowling system. "I live pretty independently considering my level of injury," he added.

The Importance of Medicaid Buy-In Program

A crucial element supporting Wolff’s independence is the Medicaid Buy-In for Working Adults with Disabilities program. This program, part of Medicaid’s expansion over a decade ago, allows individuals with disabilities to access necessary healthcare services while maintaining employment. Wolff credits this program with enabling him to lead a fairly normal life. “Without it,” he admitted, “I would be in a nursing home. The care I get at home is essential to my survival.”

His partner, Carole Johnson, stressed the life-or-death importance of the program, insisting that Wolff would not have survived as long if he had been placed in a nursing facility. “He wouldn’t have survived in a nursing home this long at all,” she lamented.

Looming Threat of Budget Cuts

As the federal government considers an $880 billion cut to Medicaid, the future of programs like the Buy-In for Working Adults with Disabilities hangs in the balance. Many Coloradans, including Wolff, are watching the developments closely with growing concern. Wolff noted, “It could all be gone. A hundred percent would be gone.”

Experts warn that if Congress proceeds with deep cuts, the state may not have the financial resources to maintain its existing healthcare programs, potentially leading to a significant increase in the number of uninsured people in Colorado. Statistics suggest that approximately 230,000 people in the state could lose coverage, further exacerbating the challenges faced by individuals with disabilities.

Hillary Jorgensen, co-executive director of the Colorado Cross-Disability Coalition, emphasized the precarious situation, stating, “I don’t know how many of them have the resources to pay for their care out of pocket.” The total annual cost of the Medicaid Buy-In program is around $238 million, shared between state and federal funds, which makes it particularly vulnerable to budget cuts.

Financial Implications and TABOR

Colorado funds the Buy-In program through the Hospital Provider Fee, which could potentially be eliminated as part of the proposed cuts. The state’s Taxpayer Bill of Rights (TABOR) further complicates matters, restricting Colorado’s ability to generate flexible budgetary solutions. Jorgensen explained, “We are in a uniquely bad situation in Colorado because of TABOR, which doesn’t really allow for any budget flexibility or creative revenue opportunities.”

If the program faces defunding, individuals enrolled may exhaust their assets and fall below the poverty line, thereby qualifying for traditional Medicaid services. However, this would mean losing their jobs and facing a downward economic spiral.

Conclusion

The ongoing debate in Congress regarding proposed Medicaid cuts has significant implications for individuals with disabilities like Curt Wolff. As he advocates for the continuation of essential services, he encourages lawmakers to think critically about the potential repercussions of budget cuts. “Where do you cut? Do you cut to the quick? Are you cut till it bleeds? That’s too far. You have to make smart decisions,” Wolff remarked. The fate of the Medicaid Buy-In for Working Adults with Disabilities program remains uncertain, but its potential elimination poses a serious threat to the health and independence of countless Coloradans.

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