Medicaid is not a program that is well understood outside the Disability community. It's been under attack since 2010. Republicans, even some who are parents of kids who have a disability, believe that returning Medicaid to the states is the best plan. Donald Trump is a prime supporter of this idea. However, many people, particularly the temporarily able-bodied, have no concept of what that would lead to, largely because they have no idea what the program does.

How Medicaid Works now

Medicaid works by having the Federal government match the funding commitment to the states.

The Feds pay roughly half and the states to pay approximately half. Some pay more, and some pay less depending on the state's financial ability. This allows states to cover more people more efficiently. There are a few rules, but most of them are good. Case in point, states must prioritize getting disabled people into community living situations rather than nursing homes (which are often cesspools of abuse).

The result is that disabled people can live on their own. Children with significant disabilities are able to get services they need such as therapy (physical or otherwise). Parents can even get in-home care for their children so they can work or get a little rest. That sort of thing is important to the mental health of the parent.

While anyone who has read my articles for any length of time knows full well that I do not consider a lack of services to be a valid excuse for murdering disabled people, it is important to note that parents do need help that Medicaid provides now.

Medicaid also provides services for adults. It provides things like job training to get people with disabilities into the workforce.

It also helps them find accessible homes. This is important not only because it helps gets them living in their communities rather than nursing homes, but because it gets them out of their parents' homes. Since parents are aging, this is a problem that has to be addressed.

What Medicaid changes would mean

In theory, the states could find ways to innovate the program if it weren't tied to the Federal government.

In practice, it would just lead to more innovate excuses to make massive cuts. While many Donald Trump supporters seem to have no problem with this idea, for people with disabilities, this would be a literal death sentence. Many of us rely on the program to not only get medical care but to stay in our own homes. Cuts would lead to more institutionalization which would lead to death.

Some Trump supporters and libertarians believe that private charity would ultimately fix this. History proves those people wrong. Private charity wasn't fixing the problem before. Anyone who thinks it will fix the problem now needs to go to GoFundMe and just take a look at the litany of unfulfilled requests.

While Medicaid is not perfect, it should not be thrown away. It does a lot of good for people and their families.