Medicaid provides health coverage mainly for seniors, people with disabilities, and low-income families.(3) In addition to covering doctor visits, hospital costs, prescriptions, and other medical expenses, it offers supports that allow people to remain independent in their homes and communities, keeping them out of institutions.(4)
People with disabilities account for more than 1 in 5 Medicaid beneficiaries under age 65.(5) Nationwide, nearly 13 million non-elderly Americans with disabilities receive health coverage through Medicaid, including more than 2 million children. Nearly half of non-elderly people with disabilities have their health care covered through Medicaid. (See Appendix Table 1.)
Medicaid is crucial for people with disabilities. It provides comprehensive health benefits and serves as the primary payer for essential long-term services and supports that help people with disabilities stay independent in their homes. Many of these long-term care services are unavailable through private insurance and are too costly for all but the wealthiest people to fund out of pocket, such as personal and attendant care services. Medicaid can also cover wheelchairs, lifts, and case management services. And Medicaid can help people with disabilities find and hold jobs. A number of states provide supportive employment programs through Medicaid that offer services to help people with disabilities join the workforce.(6)
The deep cuts to Medicaid passed by the House in the American Health Care Act, which are under consideration in the
Moreover, many of the 11 million people who have gained coverage through the Affordable Care Act's Medicaid expansion struggle with disabilities, chronic illnesses, or other health conditions (such as mental health or substance use disorders) that wouldn't, by themselves, qualify them for Medicaid. Only 36 percent of non-elderly Medicaid beneficiaries with disabilities receive Supplemental Security Income, which allows them to enroll in Medicaid without the expansion. While others may be eligible for Medicaid based on other criteria, many could lose Medicaid coverage under the House bill and wind up uninsured.
Steep Medicaid cuts would make it especially hard for children with special health care needs, including those with disabilities, to get the care they need to stay healthy, remain in their communities, and succeed in life.(9) The cuts also threaten key resources for students with disabilities.(10) In both cases, the funding cuts will leave states seeking ways to reduce benefits provided through Medicaid as well as eligibility, both of which could leave children without the care they need.
As a result, many people with disabilities would have to go without needed services or get care in an institution, and many who have gained coverage under the Medicaid expansion would likely lose it.
SNAP Cuts Would Cause Hunger and Hardship for People with Disabilities
People with disabilities account for nearly 1 in 5 SNAP participants under age 65.(13) Nationwide, about 9 million non-elderly Americans with disabilities receive SNAP benefits to help keep food on the table. More than a third of non-elderly people with disabilities receive support from SNAP. (See Appendix Table 2.)
SNAP helps people with disabilities afford the food they need.(14) Disability has emerged as one of the strongest known factors affecting a household's food security. Disability increases the risk of food insecurity -- inadequate access to food -- because it often reduces household income and increases household costs. Disability can reduce household income by limiting the educational attainment and earnings of people with disabilities, narrowing the range of jobs available to them, restricting their hours worked, and reducing the number of hours family caregivers can work given their caregiving responsibilities. Disability can increase household expenses for accessible housing and transportation, personal assistance services, assistive technology, and health care not covered by private insurance, Medicaid, or Medicare. As a result, food insecurity rates are about two to three times higher among households with members with disabilities than households without any disabled adults. (15)
Food insecurity, besides being more likely in households affected by disabilities, may also be more problematic for them. Food insecurity has negative effects on health and diet quality, and these effects may be greater for people with disabilities, research shows.(16) By providing households with income to purchase food, SNAP can reduce food insecurity for low-income people with disabilities.
The deep SNAP cuts proposed by
The budget would also end a state option to raise income limits or ease asset tests, which would disproportionately cut from SNAP people with disabilities who may struggle to afford food because they face high expenses related to their disability. Research shows that assets, particularly liquid assets such as savings, can protect these individuals from food insecurity. (19) Another proposed cut would eliminate the minimum benefit for small households, which also disproportionately benefits people with disabilities. Past House Republican budget plans have also included structural changes and other major cuts to SNAP similar to those included in the President's budget.(20) SNAP cuts of the magnitude of these proposals would inevitably mean more hunger and hardship for people with disabilities.
Housing Cuts Would Increase the Risk of Homelessness and Institutionalization for People with Disabilities
Federal rental assistance programs enable low-income households to rent modest housing at an affordable cost.(21) Three major programs -- Housing Choice Vouchers, Section 8 Project-Based Rental Assistance, and
Nationwide, nearly 1.5 million people under age 65 with disabilities live in households that use federal rental assistance to help pay for housing, accounting for 15 percent of all people receiving rental assistance.(22) (See Appendix Table 3.) About 29 percent of households receiving federal rental assistance include a non-elderly adult or a child with a disability.
Federal rental assistance helps people with disabilities meet their basic needs and maintain their independence. Many people with disabilities live on fixed incomes that often fail to keep pace with rising rents. The poorest among them typically rely on Supplemental Security Income (SSI), for example, which offers a maximum monthly benefit of
The Trump budget proposes to cut rental assistance programs while raising rents on many assisted families.(23) Cuts to housing assistance would mean about 250,000 low-income households, including roughly 75,000 with disabilities, would lose vouchers that help them pay the rent.(24) The budget would also slash public housing funding by nearly 29 percent compared to 2017, exposing public housing residents -- a fifth of whom are members of households headed by people with disabilities -- to health and safety hazards and the risk of losing their homes. The Trump budget would also cut homeless assistance grants, which are essential to communities' efforts to prevent homelessness, including initiatives to reduce long-term or repeated homelessness among people with mental illness and other disabilities.(25) Steep cuts to rental assistance would increase homelessness and worsen hardship for people with disabilities.(26)
Disability can happen to anyone -- especially with advancing age. Serious illness or injury pushes many people, including families caring for children with disabilities, into poverty, and many more struggle to afford basic needs. The cuts that the President and some members of
 "Policy Basics: Introduction to Medicaid," CBPP,
 CBPP analysis using
 "Policy Basics: Introduction to the
 "A Quick Guide to SNAP Eligibility and Benefits," CBPP,
 CBPP analysis using
 Carlson et al.
 "Policy Basics: Federal Rental Assistance," CBPP,
 CBPP analysis of 2016