If you're a disabled American, or you have a child with a Disability, you probably have Medicaid or have dealt with it at some point. Throughout the healthcare debate, various bills attempted to gut the program. The bills failed thanks to protesters and have resulted in several Twitter tirades from Donald Trump.
Per-capita switch would gut the program
In order to effectively fight for healthcare, it's important to understand what the GOP's goal is. Conservatives have never liked Medicaid and have long desired to gut the program. For all the ranting about the Affordable Care Act, most bills have slipped in steep cuts to the program, and changes that would result in steeper cuts at the state level, neither of which have anything to do with the debate but would gut Medicaid.
One of these changes is the per-capita cap.
One of the key features in almost all of the healthcare bills is switching Medicaid funding to a per-capita cap system. Right now, the Federal government reimburses states for half their spending on the program regardless of what they spend. This has allowed them to do things like help disabled people live in their communities, rather than nursing homes (most of which tend to be abusive cesspools).
If we switched Medicaid to a per-capita system, where states only got a set amount of money regardless of how things play out throughout the year, this would result in cuts to all but what is considered "optional services." Unfortunately, independent living and other programs such as the ones that help disabled people find jobs fall under the category of optional services.
The inevitable result would be forcing people, many of them young people, back into nursing homes.
Republicans consider per-capita caps an expansion of freedom for states, it would result in a loss of freedom for disabled people who have found freedom from abusive institutions. There's a reason that ADAPT put their bodies on the line to stop the implementation of these caps and will continue to do so.
The endgame is about destroying Medicaid
Many disabled conservatives (and parents of disabled people) have called the disability rights groups paranoid. Their claim is that the GOP is only trying to get people off of Medicaid who, in their view, shouldn't be there. However, one need only look at the talking points of the GOP to know what their real plan is.
They have stated numerous times that their goal is to get the government out of healthcare.
Read that statement closely. Notice that there is no caveat in that statement for the disabled. There is nothing in there about the people who the private sector wouldn't touch. There is not, nor has there ever been an "except for the people with serious disabilities" attachment to the "get the government out of healthcare" statement. When Republicans say they want the government out of healthcare, they don't just mean they want it to be taken away from people the rank and file believe are undeserving. They mean from everyone, regardless of circumstance.
For those that don't believe this, ask yourself what the point of the per-capita caps is.
What is the point of cutting Medicaid, a program that has done more for the disabled than any church or charity ever has, by nearly a trillion dollars? You can say that a cut of such magnitude wouldn't affect those who actually need it. But if you or your child need it, are you willing to make that bet?
