It’s no secret that the Great Recession has forced states to make devastating cuts to health care and social services. As the Times points out, people with disabilities and the elderly are particularly vulnerable to cuts in home care and other community-based services. The people who depend on these services are now facing greater risk of hospitalization or institutionalization, which will be paid out of state coffers, thus undermining the state’s original intent to cut costs. And because of Medicaid institutional bias, states have a great deal of flexibility to cut “optional” services like home care while preserving nursing home funding.
Unfortunately, this trend of service cuts isn’t likely to improve any time soon. The recession’s lingering aftereffects are going to be a drag on state budgets for years to come. Additional federal funding for home and community-based services would certainly be welcome, but Washington’s current preoccupation with the deficit makes that scenario unlikely in the extreme. People with disabilities and their advocates will have to wage some savage political fights just to ensure a 2% cut instead of a 5% or 10% cut. That’s likely to be the case here in Minnesota, which is confronting a $5-$6 billion deficit over the next two years. The only thing that gives me any comfort is the knowledge that I would be worse off in almost any other state.
