Most Americans have no memory of lives without Social Security and Medicare. Today, these programs provide a financial safety net and basic healthcare for seniors, lifting them from poverty so they may live with dignity. These programs are promises kept to all Americans who paid into them throughout their working lives.

Many Americans also rely upon a lesser known but equally essential federally funded health-related program—Medicaid. Medicaid covers medically-related services to one-fourth of the American population—nearly 80 million children and adults—including those too young to qualify for Medicare and too poor to afford healthcare otherwise.

Medicaid is the major funding source across the country for hospitals, community health centers, physicians, and nursing homes. Although federally funded, Medicaid is administered by the individual States which often use different names, making the program less visible to the public as Medicaid. Here in Hawai‘i, it is called Med-QUEST, in Oklahoma it is called SoonerCare, and in California it is labeled Medi-Cal—to give a few examples.

And Medicaid does something else: it provides funding for services enabling children with disabilities to receive an education and live with their families.

Today’s Americans may know little of life for children with disabilities prior to 1976. In that year, what is now the Individuals with Disabilities Act (IDEA) legislation passed by Congress guaranteed a “free and appropriate education” to all children. Before then, children with disabilities were barred from their neighborhood schools, spending their lives in back bedrooms in homes or in institutions for persons with mental retardation or mental illness. These human warehouses of our past were 20th century versions of the “lunatic asylums” and “poorhouses” of Charles Dickens’ times, lacking rehabilitative and compassionate care.

The Trump administration would take America back to all of that. Despite campaign promises (lies?) to the contrary, current budget proposals target massive funding cuts to Medicaid. Everything is on Elon Musk’s DOGE chopping block, accompanied by false claims of fraud without evidence. Trump and his wrestling executive Secretary of Education aren’t content with eliminating health-related funding. They are dismantling the Department of Education which is the key agency with oversight of legislation protecting the basic civil rights and providing educational and medically-related supports to children with disabilities.

Losing Medicaid would be catastrophic. Beneficiaries of Medicaid include those with multiple sclerosis, epilepsy, sensory impairments, spinal cord and traumatic brain injury, depression, schizophrenia, intellectual and developmental disabilities, autism, Down Syndrome, and functional limitations from chronic illnesses. Medicaid currently funds nearly 60% of residential and personal care, one-fifth of total U.S. hospital costs, and nearly one-fifth of all U.S. health related spending.

Medicaid covers long-term services, therapy, community-based support, personal care, and employment assistance. Medicaid funds medical equipment including assistive technology and mobility aids prescribed by healthcare providers. That wheelchair your family member uses to get around was probably funded by Medicaid. The long-term nursing home placement or in-home care for someone with a debilitating disease such as Parkinsons—Medicaid. Treatments for traumatic brain injury resulting from traffic or water accidents and falls—Medicaid.

For children with disabilities, the loss of Medicaid means cutting essential services to our schools, public and private. Funding could end for specialized transportation and nursing, speech-language pathology, audiology, occupational therapy, physical therapy, personal care, counseling, and psychological services.

Cuts to Medicaid means denying millions of Americans access to desperately-needed supports and the right to live with dignity. Such cuts cannot make America great again—they would only make our nation cruel.

Luanna Meyer, PhD
Carol Reinson, PhD – Former Little Falls resident