Spinal Cord Injury Journal

Obama and Trump Medicaid Changes Now Hurting People with SCI

Written by Spinal Cord Team | December 10, 2020

It’s crazy to imagine but one in five Americans are now on Medicaid. This is a major shift from the number of people on the program 5 years ago. Thanks to two administrations, a lot can change in 5 years, and that certainly has been the case with Medicaid. It seems that people with disabilities, including many with spinal cord injuries, are beginning to see the effects of these changes, and it’s not good. From Iowa to Louisiana, they are being felt across the country.

In a previous blog post, we talked about how some states are now privatizing their Medicaid programs to save costs. This “cost savings” idea is cutting services from thousands of people with disabilities, from home health care hours being slashed to people being denied medical equipment, or being put on waiting lists for things like wheelchairs and catheters. Many people with disabilities never thought this day would come, especially in states like Iowa that are traditionally blue states with generous Medicaid programs.

In 2016, however, Iowa became one of the first states to privatize their Medicaid program, and now two years later disabled Iowans are seeing some ridiculous cuts to their health care. One story is Jamie Campbell, a C2 quadriplegic from Des Moines, Iowa. His privatized Medicaid provider, UnitedHealthcare, tried to slash his home health aide hours but he fought and won.

Unfortunately, they are now trying to slash his hours again from 158 hours to 66 hours per month. This story really shows the ruthlessness of these private corporations in an effort to save costs.

Read More of Jamie Campbell's Story


And this is just one story. If these companies have the audacity to cut hours from someone with Jamie's level of injury, just think of what is happening to people with less severe disabilities. In many states, people with disabilities are still waiting to be approved for Medicaid. This is another larger problem stemming from a previous administration. When President Obama signed the Affordable Care Act, he signed a bill that transformed Medicaid and allowed millions of able-bodied people to join the program.

While this was great, as everybody deserves health care in my opinion, people with disabilities, especially those with severe spinal cord injuries, are now seeing their badly needed health care diminish. This is definitely a new phenomenon that is occurring post-Affordable Care Act.

Another area of Medicaid that the GOP is cutting is the disability services such as the accessible transportation that ensures students with disabilities are able to get to school. While some conservatives have criticized this cost, school districts need this money and have depended upon it for years. This cut has the power to disrupt the daily flow of many families and individuals getting to work each day, leaving their kids being stranded and at home.

But it could be worse. The Trump administration is now trying to allow states the ability to force work requirements upon Medicaid recipients. Kentucky and Michigan are a couple of the states attempting to enforce this, although the Kentucky's Medicaid work requirements were recently blocked by a federal judge. Even though people with SCI are exempt today from proposed work requirements, there is no telling how this could also be altered by the Trump Administration going forward.