Block Grants and Medicaid Funding

Written by Kenny Maestas

MEDICAID MYTHS

• Myth: Seniors, PWD, pregnant women, and children forced on Medicaid waiting lists under expansion.
  • Truth: No waiting lists to enroll in Medicaid. States must enroll all eligible beneficiaries (i.e., children, seniors, PWD)
• Myth: Medicaid expansion led to longer waitlists for people requesting home and community-based services (HCBS)
  • Truth: Medicaid expansion has improved access to HCBS (9 of 11 states with no waiting lists are expansion states).
• Myth: Medicaid Expansion has been an economic drain.
  • Truth: PWD, caretakers, and home care workers have all benefited directly from Medicaid expansion. Colorado added many jobs, and Medicaid helps the economy, especially in rural areas.
• Myth: GOP Healthcare bill won’t harm seniors and PWD currently receiving HCBS.
  • Truth: Its per capita cap would make it hard for states to meet the need for HCBS, and cuts will increase yearly.
• Myth: States will be able to manage better Medicaid funds keeping coverage for current recipients.
  • Truth: States must cover nursing home care under Medicaid. So, cuts to Medicaid will be to PWD living in the community. HCBS waiting lists will grow. Some states might end programs.
• Myth: Medicaid expansion members are just lazy, able-bodied people.
  • Truth: There’s a minimal number of able-bodied adults not working, but they’re a distinct minority. Expansion members include many PWD, and others are low-wage workers whose employers do not provide insurance.
• Myth: Giving expansion higher match somehow hurts those on traditional Medicaid
  • Truth: The higher expansion gave states infrastructure to improve the program. People with disabilities, elders, and children benefited from these improvements. The match for traditional populations remained uncut.
• Myth: Medicaid patients cannot get doctors.
  • Truth: Federal statistics gathered over recent years show that the % of physicians accepting new Medicaid patients has remained around 70 percent. No support for the idea that the participation rate has declined under the ACA.

Continue reading “Block Grants and Medicaid Funding”

Healthcare and Prosperity in America

By Timothy Postlewaite

Healthcare is crucial to prosperity in America, as it assists in the facilitation, participation, and productivity in a multitude of aspects from the standpoint of those whom the rest of society would categorize as “underdogs,” individuals who require more assistance to find their version of “normalcy.”  Medicaid is a prime example of a program that attempts to assist with this, as it assists the impoverished and the disabled by allowing them to have the opportunity to live a healthy and productive life. From an early age, I have experienced the pros and cons of Medicaid. The program allocated funds toward my first electric wheelchair, which allowed me to enter Kindergarten with the ability to participate with a diverse group of kids.  Moreover, not only did this experience begin the process of acclimating me to social expectations, but it also assisted me in terms of forming my identity, providing me with a steadfast foundation of freedom and independence, two characteristics that have remained with me to this day. Continue reading “Healthcare and Prosperity in America”

Medicaid’s Appellate Process Gone Wrong

By: Stacy Warden/Author of Noah’s Miracle

The legal process isn’t easy for an already struggling family who is overwhelmed with the care of a child or family member. It’s intimidating from the start.  When a family is issued a denial they are provided with a notice of the denial and advised of their rights. However, there’s a tiny little clause that says should you lose your appeal that you very well may have to pay the State back in services and legal fees.  Which, for most families is an automatic discouragement from pursuing their appellate rights before an Administrative Law Judge. Continue reading “Medicaid’s Appellate Process Gone Wrong”

Medicaid law forcing caregivers to be tracked by GPS inspires privacy backlash from Colorado’s disabled community

The aim is to reduce Medicaid fraud by requiring therapists, respite workers and nurses to log in and verify their location when they visit someone’s home to provide care. But backlash, especially from the parents of children with disabilities, has been fierce.

“We’re disabled, not criminals!” shouts one petition. Continue reading “Medicaid law forcing caregivers to be tracked by GPS inspires privacy backlash from Colorado’s disabled community”

The Vital Importance of Advocacy in Colorado

by Bryce Rafferty, CDASS Participant

While I wasn’t born in the state of Colorado nor did I grow up here, I am beyond thankful for this state, it’s people, and the public healthcare that makes life in Colorado that much better for persons with disabilities. Most people know Colorado for its mountains, but most don’t know that Colorado State Medicaid is one of the best in the union. Speaking with another quadriplegic like myself from Iowa, I heard about how Medicaid in his home state falls far short of the coverage and quality of care that I enjoy on a daily basis. However, being on federal health insurance anywhere has its fair share of challenges, and it is the responsibility of the people to hold the government accountable and maintain the positives when they are threatened by changes or pitfalls in policy. Continue reading “The Vital Importance of Advocacy in Colorado”

What I Like and Don’t Like about Medicaid

by Dale Buterbaugh

My name is Dale Buterbaugh. I have the opportunity to serve on various  statewide Health Care Policy and Financing committees as well as some local committees.  I must say that I have learned a great deal and even shared a few ideas as well, They all have been very receptive and encouraging at the same time. What do I like and don’t like about Medicaid? Boy I really had to think about this and how it has either been good or what I think could change with the Medicaid system. This is hard as I am trying to think not just about myself but of others, too. I have been on Medicaid most of my life, and like any system it does have its ups and downs. It saddens me that some of the much needed medical care stops for those who are over 18 and then picks up again with people over 60 but with a lot of restrictions so to speak, like i could get my eyeglasses paid for or hearing aids etc all that till I turned 18. Much of this is still needed throughout my adult life. Right now I have no way to afford them unless I can solicit donations or foundations like Easter Seals or Hear Now to help me off-set the cost of the hearing aids . I wish all individuals could go for 30 days without hearing and see how it affects you when you lose the ability to hear.  When it comes to glasses, they are considered a luxury for me as I can not afford them and it takes me a long time to save to get a pair.

 I hate that not just Medicaid but most all insurance systems require prior authorization to get some services which  could mean the difference between life and death for some people, I guess that we could be thankful that if a person is having a heart attack that we can be seen right away. Someday that could change and we might have to call the dr a few days ahead and, say hey, “Doc I think I am having chest pains, I need appointment ASAP.” Or have the fear of doctors turning you away because you have Medicaid and not Blue Cross etc.. I will say thank you to Medicaid for the fact that my sister is a leukemia survivor and has been cancer free for a long time now. There are times that she feels that either she owes something back or has taken advantage of a system that without it, she would not be here with us today. She just feels like she should have died and not take the medicaid help. It did save her life. I am thankful and grateful for Medicaid helping her. 

I could have used some short time long term care services during my time of healing from a recent surgery to repair my Achilles’ tendon. Help to get around town to be independent and get out of the house, but I could not afford the rides nor do I qualify for the service. I just stayed  home and watched TV all the time. I am not able to get out and exercise inorder to be in better health But at the same time I do not qualify for that type of services which saddens me and frustrates me. That I have to give up my freedom just because I can’t afford or get help that I would like or feel that I need. People that run the insurances say “Oh you had a common illness so therefore we are going to limit your care and needs”. But in reality it does not work that my life should not be compared to the theory if  there’s one bad apple then the whole bunch are bad etc. I am an individual not a whole group, so please don’t treat me like I am a group and not a person

Medicaid Buy In for Working Adults with Disabilities

by Cara Jean Reimann

I am one of many Colorado residents who has had health insurance only sporadically. While I am a supporter of the Affordable Care Act, the premium costs and deductible charges were prohibitively expensive for me to have consistent access to health care. I think Congress caved too much during those days and allowed private insurance to dominate the narrative about health care. 

In 2018 during a period of time when I was uninsured, I had a medical crisis and went to the emergency room at Denver Health. I received amazing care there, including surgery and 10-day in-patient stay. My last day there, a woman from Enrollment Services came to my room and talked to me about my situation. I had been thinking I would have to go sell my house and live on friends’ couches while I deal with my cancer diagnosis, but she determined that I qualified for a Medicaid plan! 

I was unable to work regularly for several months while I underwent cancer treatments and recovered from my surgery. I am now working again full-time, but I require medical supplies for the rest of my life, and cancer screenings are part of my regular health care, too. CCDC’s advocate Donna Sablan helped me navigate Colorado’s Medicaid rules and found that I qualify for Medicaid buy-in, since I’m now working full time. 

I have always been a strong supporter of Medicaid expansion, and I hope everyone will someday be able to use this amazing program. I support Medicaid for all, regardless of where people live, and Medicaid buy-in should benefit all people who want to use it, not just people under the age of 65. 

**All Blogs reflect the opinions/experiences of people with disabilities or family members of people with disabilities. They do not reflect CCDC’s official position on any portion of Medicaid services.

‘The system is broken’: Medicaid buy-in age limit forces disabled to become impoverished

By: Jaclyn Allen

A Door Opener

by Haven Rohnert

After a decade of being a stay at home parent, when I was 19 to 29, my children’s mother and I parted ways. It was the first time I had to survive on my own, with complicated medical conditions, hundreds of miles away from close friends and family. 

I got on a hospital’s program for people with low incomes, which provided me the minimum medical treatment to survive. When I secured SSI, during these rough times, I received Medicaid which gave me better coverage, to combat my disabilities.

I stopped having the type of seizures which caused me to wake up in the hospital many times. I still had 3 to 5 partial seizures a week, so I and my neurologist discussed surgery as an option. 

I had my first surgery and that stopped every type of seizure, for over a year. After I started having symptoms that felt like a seizure could come on but never did, we discussed having a second surgery. I had the second surgery. In about a week, I will have a hospital stay to see if it’s safe to start tapering off one medication at a time. We started tapering of one medicine approximately 7 months ago, but I had reactions which may be seizures or possibly just withdrawal symptoms. Being monitored in the hospital will let doctors and I know what causes the reactions.

Through all this, Medicaid has been by my side and has kept me safe and provided treatment that I couldn’t afford with other insurance. Medicaid has also been great for preventative treatment that has allowed me to raise my kids and work safely for over 11 years. With Medicaid’s 1619 B program, which allows people with disabilities to keep their insurance, after surpassing the income limit, if a person cannot work without the coverage, I was able to work my way off all other government benefits. I am happy to pay for my insurance now, through the Medicaid buy-in program. Medicaid is a lifesaver and a door opener. 

**All Blogs reflect the opinions/experiences of people with disabilities or family members of people with disabilities. They do not reflect CCDC’s official position on any portion of Medicaid services.

Medicaid, the Good and the Bad

by Kristy Arellano

My name is Kristy and I am a volunteer advocate for Colorado Cross-Disability Coalition.  I am also a mother to daughter with a severe brain injury who requires 24/7 care for all her needs.

When I was little we did not have healthcare insurance.  I remember going only once to the doctor when I had a bad case of strep throat.  We rarely went to the dentist and for the most part we all were healthy and able to avoid needing health care.  Looking back now I realize we were poverty level and very well could have qualified for government services.  We never wanted for anything as my mom was a careful shopper who frequented thrift stores for most of our clothes and worldly goods.

Fast forward to May 2013.  I was a working mother of three when my daughter was permanently injured during a suicide attempt.  She lost oxygen for an undetermined period of time causing a severe brain injury.  She spent a total of about 8 months in the hospital during the first couple of years after her injury. At the time we had Kaiser insurance through my employer.  

I had no idea how we were going to make it through such a tragedy, emotionally or financially but I knew we wouldn’t give up!  I remember receiving a letter from Kaiser during the first hospital stay, which lasted 4 months, stating we had exhausted our rehabilitation services.  I remember the terror I felt at that moment knowing we could not possible care for our daughter on our own.  I was scared the hospital would refuse to continue to treat out daughter and that we might be discharged with a 14 year old that needed round the clock care just to survive.  Insert a hospital case worker.  She explained that our daughter would qualify for Medicaid based on her disability.  After jumping through the required hoops and getting misinformation about a variety of waivers we eventually navigated our way through the process to get her set up in the system.  

She is now days away from turning 21.  Her health has improved, but she still requires 24/7 care to ensure she doesn’t end up back in the hospital. I am so thankful for everyone who went before us to fight for these benefits and for those who continue to fight for them.  I still struggle with resources to navigate the changing landscape as she moved from children’s services into adult services.  Currently we have 22 hours daily approved nursing that decreases to 16 hours once she turns 21 because magically as an adult she will no longer need the level of care that she once did, right?It is a constant challenge to find and keep qualified nurses to care for her and never have we had staffing for all the hours she has been approved for.  Low wages and minimal employment benefits through the agencies make home health nursing jobs less desirable then what hospitals and other institutions can provide.  We are consistently scrambling to find ways to supplement what she needs by what’s provided.  

Medicaid has been a huge blessing to our family.  With Medicaid we have been able to bring our daughter home and for the most part have the supplies, medication and services that we so desperately needed to continue to care for our daughter.  We have learned about state Medicaid and strived to educate ourselves about the variety of waivers she has been eligible for throughout the years.  It has been a huge struggle to educate ourselves to make the best decisions about what she needs and then to advocate so that we can get the right medical equipment, in home assistance for care, medications and daily supplies.  I had to quit my full time job just to manage her care and ongoing needs.  I fight weekly with providers, insurance and/or Medicaid to ensure she has her basic needs met.  While it’s not a perfect system, I don’t know how we’d manage without Medicaid to give our daughter a comfortable meaningful life at home, where she belongs, with her family.

**All Blogs reflect the opinions/experiences of people with disabilities or family members of people with disabilities. They do not reflect CCDC’s official position on any portion of Medicaid services.