Medicaid is InclusionPosted: June 27, 2017 Filed under: advocacy, disability | Tags: ACA, AHCA, BCRA, disability, Down syndrome, Healthcare, inclusion, Medicaid, Obamacare, Trumpcare 4 Comments
Let me tell you a story. While you read, I want you to be repeating this in your mind: Medicaid is inclusion. Medicaid is inclusion. Medicaid is inclusion.
The last century has been increasingly positive for people with disabilities. in 1949, the average life expectancy for a person born with Down syndrome was 12. Today, it is 60. People with Down syndrome were systematically excluded from society, with very discernible consequences. Stigmatized, lacking appropriate medical care, shut out of schools, denied meaningful work, warehoused in dangerous and often abusive institutions tangibly damages one’s chances for a long, meaningful life.
How does society attempt to rectify the stigma and prejudice that people with disabilities face? We use our collective resources to give disabled people a fair shot at living an inclusive, meaningful life. Healthcare. Education. Employment. Living at home. This is not only a financial imperative (people in institutions and experiencing health crises are expensive) but also a moral imperative (we value each other as equally worthy of participating in society).
Again: Medicaid is inclusion.
American Law and the History of Two
Judith Scott was born in 1943. She had Down syndrome, her twin sister did not. At the seven years old, deaf but never diagnosed, she was sent to live in an institution. She was thought to be “uneducable.”
In 1945, President Truman advocated for a federally funded insurance program. He did twice more, unsuccessfully. He said (emphasis mine):
“Millions of our citizens do not now have a full measure of opportunity to achieve and enjoy good health. Millions do not now have protection or security against the economic effects of sickness. The time has arrived for action to help them attain that opportunity and that protection.”
Over twenty years later, Congress passed the Social Security Amendments of 1965 by large majorities, establishing Medicaid for vulnerable populations. When he signed it, Lyndon Johnson credited Truman for being the original force behind the bill.
Judith Scott was 22 years old when Medicaid became law, 15 years into her time in an institution.
The same year, Congress passed the Elementary and Secondary Education Act of 1965 (ESEA), ensuring funding for schools to provide all children with a quality education. Since then, the Education for All Handicapped Children Act (EHA) and the Individuals with Disabilities Education Act (IDEA) mandate that disabled children must receive a free and appropriate education.
Judith Scott was 43 years old when her twin sister became her guardian and brought her home. It was 1986. I was five years old, and living in the Bay Area, where the Scotts also lived.
The Americans with Disabilities Act (ADA) passed in 1990 and signed into law by George H. W. Bush. Nine years later, the United States Supreme Court ruled in Olmstead v L.C. that states were required to support individuals with disabilities in their communities rather than in institutions.
Judith Scott lived with her sister for almost twenty years before she passed away in 2005. We lived in the town over from her. Seven years later, I gave birth to a baby with Down syndrome.
The Past Lights Our Future Path
I know about Judith Scott because after was released from government care, she went on to be a world-renowned artist. You can read about her work here.
The story of the Scott sisters made me weep, hope, and mourn. I wept for Judith, knowing that had my son been born then, he might have suffered a similar fate. I hoped that the world might one day appreciate the fruits of my son’s labors—whatever they may be—in the same way that Judith Scott’s art was appreciated. I mourned for what might have been, if only society had seen her intrinsic worthiness and included her from birth.
In 2012, the world seemed entirely different than it had been in 1943. When my son was born, I truly thought that inclusion was an attainable goal for him because of the legal protections and social safety net he had been born into.
To be clear, I want is true, lifelong inclusion. In Truman’s words, I want him to have the “full measure of opportunity” that every non-disabled child has. Full stop. That means that through appropriate supports, he would have not just a shot, but an equivalent shot to what everyone else has. (And don’t for a second think that because you are not disabled, you don’t use supports. Your supports are simply seen as de rigeur for “normal” life.)
We know that in a classroom, inclusion is better for all involved. Children with and without disabilities make better gains. We all enjoy more diversity and stronger communities.
The benefits of true classroom inclusion generalize outside the classroom as well. Medicaid, with all its flaws, is what helps gives people with disabilities that equivalent shot at an inclusive life. Medicaid dollars translate to Early Intervention, special education funding, basic and specialized medical care, home based services (to avoid institutionalization), respite hours, job training, mobility aids, communication devices, therapy. Medicaid is that extra crate to stand on in order see the game of life.
One more time: Medicaid is inclusion.
When Judith Scott was born, there was no Medicaid, no ADA, no IDEA. What life would she have lived, if she had been born 69 years later, when my son was? I think she could have had Early Intervention services and learned ASL. I think she could have gone to school with her twin sister. Stayed with her own family. Lived happier. Lived longer.
Judith Scott should have had more. Today’s Americans with disabilities should have more.
In case it needs explaining: if it hasn’t already, disability will likely touch you. It probably already has and you may not know. Valuing disabled lives, values all of us. By dismantling Medicaid, we are harming our bodies, our collective financial health, and our moral compass.
This story isn’t over. I wish that I could write it by myself, but I cannot. We humans are blessed and cursed with our capacity for collective action. 56.7 million Americans (nearly 1 in 5) are disabled. Medicaid covers 10 million elderly and disabled Americans, 33 million children, half of all births. The nonpartisan Congressional Budget Office estimates that in the next ten years, 22 million more people will lose insurance. After ten years, the numbers will grow even more.
There are 100 senators. There are millions of us. We can right this ship, if we act now.
“Doing Damns the Darkness”
(I learned that phrase from Dave Hingsburger, who spends his life and career advocating for people with disabilities.)
Center on Budget and Policy Priorities on why Medicaid actually works.
What are others saying?
National Down Syndrome Congress (NDSC)
Disability Rights Education and Defense Fund (DREDF)
American Association of Retired Persons (AARP)
American Medical Association (AMA)
The United Nations (yes, the UN!)
Hospital groups, pretty much every disability group, nurses…
Need I say more?! Get to work, friends. The links above also contain calls to action that you can follow.