My wife and I slept restlessly on election night. The results were not yet final but things weren’t looking good.
In her restless stupor, she muttered the words “block grants.” That summed up quite well the deep anxiety a lot of disabled folks are feeling now that the squatter that used to occupy the White House is getting ready to occupy it again.
“Block grants” is a term that Republicans use to make it sound like they’re not really trying to cut Medicaid, even though that’s exactly what they’re trying to do. One of the great things about Medicaid is that it has always been an open-ended financial commitment. The state and federal governments share the annual cost of serving all those covered by Medicaid in a given state, whatever that cost may be.
But converting Medicaid allocations to block grants would mean each state would receive a fixed amount of money each year. And if it’s not enough to fund everyone on Medicaid through the year, states would have to cut eligibility, services, or reimbursements, or do whatever else they might have to do to make up for the deficit.
That’s a cut, no matter how you spin it.
During the squatter’s first occupation, there were many attempts to gut Medicaid in this manner. Medicaid block grants were a central feature of the multiple failed Republican efforts to repeal the Affordable Care Act. The squatter also attempted to convert Medicaid funding to block grants in federal budgets he proposed and by other means.
And now there’s Project 2025, a voluminous blueprint organized by the thick-skulled Heritage Foundation intended to provide policymakers with an effective means for enacting a far-right political agenda.
Many expect the squatter will look to Project 2025 for guidance (even though he distanced himself from the conservative plan during his campaign) as he eagerly attempts to screw up whatever he didn’t succeed in screwing up the first time around. But the Center for American Progress (CAP) warns that if the Project 2025 agenda is fully enacted, it would gut Medicaid not only by instituting block grants but also by slapping harsh new restrictions on recipients, such as eligibility time limits and lifetime spending caps. CAP says that the proposed lifetime limits on Medicaid endangers the coverage of up to 18.5 million Americans.
The potential for serious harm goes far beyond Medicaid. According to the Disability Rights Education and Defense Fund (DREDF), Project 2025 would have a “devastating impact” on the disability community if the changes it seeks in the Affordable Care Act and in federal policy areas such as education, transportation, and housing were to become reality.
I don’t know what kind of nightmare my wife was having on election night. But she’s lucky—she can still wake up and realize that it’s all just a terrible dream, at least until the squatter is officially back in the White House.