The Crucial Role of Medicaid

posted by Katie Slade on Tuesday, May 13, 2025

Watching "It's a Wonderful Life" has become a cherished holiday tradition for many, including myself. This classic film tells the story of George Bailey, who, with some help, realizes the profound impact his life has had on his community and learns to appreciate his own existence.

As Medicaid faces unprecedented uncertainty at an alarming speed, I can't help but wonder what life would be like for persons with a disability without the person-centered supports assisting with activities of daily living, medication management and employment support, among many other crucial and life-saving services almost exclusively funded through Medicaid.

1. Loss of Independence: Without Medicaid, many would lose access to home and community-based services (HCBS) that enable them to live independently. This could force people into nursing homes or state-run institutions. Imagine an 18-year-old living in a 24/7 locked facility, not because they need to be there, but because they have nowhere else to go. We see this regularly. Recently, we brought an individual into HCBS and watched them flourish and contribute to their community. Not to mention, HCBS is more cost-effective than institutional care and aims to increase independence, potentially reducing reliance on Medicaid over time.
    
2. Employment Barriers: Many people with disabilities rely on Medicaid to support their ability to work. Without it, they might be unable to maintain employment, further limiting their independence and financial security. We've seen great success in supporting people with disabilities in finding competitive integrated employment. Sixty-six percent of those we serve in employment services work 20-31 hours a week. Imagine if all these individuals were pulled from Iowa's already strained workforce.
    
3. Consistent Staffing: Rising costs make it difficult for employers to maintain competitive wages and benefits needed to attract talented employees to direct support roles. Without staffing stability, imagine meeting someone new every time you needed intimate support like showering. Our ability to provide high-quality services relies on a stable workforce.¹
    
4. Access: Cuts to Medicaid will directly impact the services providers can offer. Providers may have to make difficult decisions and cut services they can no longer afford. Needs will go unmet, waitlists will grow, and people will be hurt. Families would experience increased strain as they try to fill the gap left by the loss of Medicaid-funded services, potentially impacting their own financial stability and well-being.

By no means is this an exhaustive list of the ripple effects cuts to Medicaid would have on individuals, families, and communities. Unless more people educate themselves, take a stand, and reach out to their legislators, our story may not have a happy ending as portrayed in the classic movie.

Yet, I have hope because our community is strong. In the movie, George's community rallied around him; many went to great lengths to ensure he weathered the storm. I sure hope we can count on you to rally around the 300 people we serve who receive life-changing services funded almost exclusively through Medicaid.

We've created a page on our website with all the resources and tools you need - click here to view our advocacy page.

Reference:
[1] https://www.ancor.org/wp-content/uploads/2024/12/DSP-Workforce-Crisis-1.pdf