Rachael Cowan: Medicaid HCBS needs your support

Kaboompics.com

Published: 05-15-2025 12:52 PM

Most of us will become disabled at some point in our lives. Whether through accident, illness, or simply old age, we will all join the largest minority in the U.S. For decades, institutionalization was standard for people with disabilities. Conditions were commonly squalid, overcrowded, and abusive.When the deinstitutionalization movement gained momentum in the 1960s and 70s, we developed support systems to help people with disabilities live on their own.

In 2021, 7.5 million people used Home and Community Based Services (HCBS) through Medicaid. HCBS allows disabled people today to live independently. People now have the dignity and freedom to live in their own homes, with personal care aids (PCAs) who help with daily tasks like food preparation or mobility assistance. With the help of our PCAs, we work, shop, and are involved in the community. But the current administration risks cutting $2.3 trillion from Medicaid — not only a cut to health care, but for the disability community, cuts to a lifeline.

If Medicaid and HCBS are cut, we will see institutionalization rates rise as we lose the supports we need to live independently. And this isn’t just about us, it’s also about you. When, not if, you become disabled, where will you want to live? At home with help, or in an institution? Without Medicaid, we won’t have options open to us as we age. If we don’t support Medicaid now, our only option will be to return to the age of institutionalization.

Rachael Cowan

Amherst

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