Obama vs. Romney: The Bottom Line

All things considered, the 2012 presidential election comes down to one issue for people who care about people with disabilities -- and that's health coverage. Put aside the misleading attack ads and confusing statistics, and consider the following facts.

• Fact 1: The Affordable Care Act prevents insurance companies from denying coverage based on pre-existing conditions or disabilities.
• Fact 2: The Affordable Care Act expands Medicaid coverage for people with disabilities.
• Fact 3: Governor Romney has vowed to repeal the Affordable Care Act on his first day in office.

From the Arc of the United States, read "How the Affordable Care Act Helps People with Disabilities."

Having a major health need, or a chronic health need like a disability, can easily lead to bankruptcy even for working Americans. In Massachusetts, Governor Romney implemented a plan very similar to the Affordable Care Act. Now he wants to deny coverage to 45 million Americans, including veterans, families living in poverty, and people with disabilities. Is that the America we want?

Advocates Agree: Health Care Law is Good for People with Disabilities

No presidential election comes down to one issue, but you could argue that the choice between President Obama and Governor Romney comes down to two -- the economy and health care. Obama supporters will tell you that the president inherited a big mess, and the economy is showing signs of improvement as a result of his actions. Romney supporters will say we're on the wrong path and need a business leader like Romney to set a new direction.

For health care, Obama supporters will tell you that health care reform is a major success because it guarantees coverage that can't be taken away, even for people with pre-existing conditions. Romney, on the other hand, has vowed to repeal the Affordable Care Act on his first day in office.

While others will debate those topics, my focus is whether the president's version of health care reform helps or hurts people with disabilities. The consistency of views among major disability organizations is revealing. As nonprofits, these groups do not endorse candidates, but listen to what they had to say when the Supreme Court upheld major portions of the legislation in June 2012. (Links are to more complete statements.)

“People with disabilities and their families have their lives dictated by the status of their health insurance. The Supreme Court’s ruling today tells these families they can make decisions about what is best for them as a family, and not be controlled by fear of losing health insurance coverage.” --Katy Neas, senior vice president of government relations at Easter Seals

“People with intellectual and developmental disabilities have been waiting for generations for the insurance reforms put in place by the Affordable Care Act.  Today’s ruling removes any doubts that the law Congress enacted should stand and will benefit millions of people with and without disabilities. It ends discriminatory insurance practices and makes health coverage more affordable and accessible – important protections which too many people with disabilities have been deprived of for too long." --Marty Ford, director of public policy, The Arc

“Today’s court decision will ensure that health insurance companies cannot deny coverage based on preexisting conditions or discriminate based on an individual’s health status. This is the essence of why the disability community supported the ACA and we are thrilled that the Supreme Court decision protects these reforms that are at the heart of health reform efforts.” --Donna Meltzer, Chair, Consortium for Citizens with Disabilities

“This decision is a victory for all Americans. It means parents of a child with cancer won’t face bankruptcy paying for his treatments because of the insurance company’s lifetime cap. It means a woman with Multiple Sclerosis will receive the same health coverage as her colleagues who do not have a pre-existing condition. It means more people with disabilities will be able to live full lives in our communities rather than nursing homes.” --Mark Perriello, President and CEO, American Association of People with Disabilities

 "For millions of Americans with disabilities who rely on home and community-based services to live, learn, and earn in America, the ruling today by the Supreme Court on the Affordable Care Act is arguably the most significant decision since passage of the Americans with Disabilities Act 22 years ago.” --Jonathan Young, chair of the National Council on Disability

For more information:
"Top Reasons Why The Arc Supports the Affordable Care Act"
"Health Care Ruling A Win, Disability Advocates Say," by Michelle Diament of Disability Scoop.

Family Videos: "Don't Cut Our Lifeline"

The Arc has launched a campaign called "Don't Cut Our Lifeline,"which underscores the very real impact Medicaid funding has on families living with disabilities. These videos are powerful reminders that when we talk making radical changes to government programs -- and slashing funding -- we're talking about people's lives.

"Don't Cut Bailey's Lifeline":

"Don't Cut Greysen's Lifeline":

"Don't Cut Clare's Lifeline":

Medicaid Cuts Threaten "Lifeline" for Families

The Arc, which has been advocating for people with intellectual and developmental disabilities for 60 years, is taking a powerful stand against proposals to slash funds for Medicaid and impose spending caps -- both of which could have devastating consequences for people with disabilities and their families.The Arc's position paper for its "Don't Cut Our LIfeline" campaign states the concerns very clearly:

The Arc Opposes Spending Caps and Deep Cuts to Medicaid

Spending caps and deep cuts to Medicaid can lead to block grants and other structural changes that will devastate the Medicaid program and put the health and safety of people with I/DD at risk. Block grants could force bad choices and cause substantial conflict as groups with diverse needs compete for scarce dollars. 

What is at Stake for People with Intellectual and Developmental Disabilities?

While there is no way to be certain about what states would do, we know there will be real life consequences, such as:

• Losing home and community‐based services and supports. Waiting lists would quickly grow and it could create a crisis for the 730,000 people with I/DD living with aging caregivers.
• Losing other critical services such as personal care, prescription drugs, and rehabilitative services. If funds become scarcer, states may decide to stop providing these services altogether.
• Being forced into unnecessary institutionalization. We could return to the days when states “warehoused” people with disabilities in institutions. Federal quality standards would either be diminished or eliminated and states might once again see this as an acceptable policy option.
• Shifting the costs to individuals or family members to make up for the federal cuts. The costs of providing health care and long term services and supports will not go away, but will be shifted to individuals, parents, states, and providers.
• Losing their entitlement to Medicaid. Currently if a person meets the eligibility requirements (generally poverty, age and/or disability), he or she is entitled to the services available under the state Medicaid program. People could lose all access to health care services.

Side by Side: A Look at the Issues by The Arc

Founded in 1950, when few programs were available for people with intellectual disabilities, The Arc is the largest national community-based organization advocating for and serving people with intellectual and developmental disabilities and their families. As a 501(c)3 nonprofit, the Arc is legally prohibited from taking positions in support of or in opposition to any candidate for public office. But the organization has created one of the best analyses of the Democratic and Republican Party platforms on its priority issues.

Download the document here.

I encourage you to review this entire eight-page document for yourself, but here are a few of my observations.

1. Education
President Obama has expressed his support for the Individuals with Disabilities Education Act (IDEA) and has stated that it would be more effective if fully funded.

The Republican platform supports the IDEA's "goal of minimizing the separation of children with disabilities from their peers," but it does not support the program itself. In addition, I can tell you firsthand that the next sentence reveals a big disconnect from the reality of people with disabilities: "We urge preventive efforts in early childhood, especially assistance in gaining pre-reading skills, to help many students move beyond the need for IDEA’s protections." Yes, families should have access to early intervention (but Romney-Paul aren't offering additional funding for that) -- but even the best programs will not eliminate the needs for long-term support.

The Republican platform says most IDEA money should be provided to families in the form of vouchers. Read my recent post on this topic.

2. Civil Rights
No candidate is going to come out against civil rights. There are really no clear differences between the platforms, except the Republican platform specifically asserts "the sanctity of human life and affirm that the unborn child has a fundamental individual right to life which cannot be infringed."

3. Medicaid
The Republican platform encourages an overhaul of the Medicaid program, saying "It is simply too big and too flawed to be managed in its current condition from Washington." It encourages shifting power to the states: "For the aged and disabled under Medicaid, for whom monthly costs can be extremely high, states would have flexibility to improve the quality of care." What's not stated is that they would also have the flexibility to not improve the quality of care, and the option to reduce care.

The Democratic platform: "The President and the Democratic Party will fiercely oppose the harsh cuts in Medicaid that would inevitably lead to no or significantly less health care for millions of Americans with disabilities, workers with disabilities, and families raising children with autism, Down Syndrome, and other serious disabilities."

Read The Arc's position on Medicaid cuts.

4. Medicare
The Republican platform calls for an overhaul of Medicare, Social Security, and Medicaid, with a focus on personal responsibility and free market competition.

The Democratic platform: "Nearly 50 million older Americans and Americans with disabilities rely on Medicare each year, and the new health care law makes Medicare stronger by adding new benefits, fighting fraud, and improving care for patients. And, over 10 years, the law will save the average Medicare beneficiary $4,200."

Voting & Policy Resources from Leading Disability Groups

I have my own opinions and biases, so I want to offer several other resources to help you educate yourself about the issues that are important in the 2012 election and give you several ways to register to vote and make sure that everyone you know votes, including those with disabilities. Here are a few of the best resources I've found. Do you have others to share?

The Arc's "Get Involved" Section
This website section summarizes issues important to The Arc, a detailed comparison of the party platforms, and summaries of Medicaid, civil rights, education, employment, Social Security, and other issues. Also links for register to vote and get to the polls. Do you know that in 2008, the voter turnout rate for people with disabilities was 7.2 percent lower than people without disabilities? The Arc's theme for this election year is "We've Got the Power. Vote in 2012."

Autism Speaks Election Center
Includes a summary of policy principles, a link for voter registration, and signup for Autism Votes to get involved and to receive action alerts. Also a news section that tracks the candidates.

Consortium for Citizens with Disabilities
This is a coalition of about 100 national disability organizations working together to advocate for national public policy that ensures the self-determination, independence, empowerment, integration and inclusion of children and adults with disabilities in all aspects of society. Their site has excellent commentaries on issues of importance to people with disabilities and their families.

Disability Scoop

Disability Scoop is a nonpartisan website that calls itself "the premier source for developmental disability news" -- and it's hard for me to argue with that description. Over the next few weeks, you might want to follow their political news. And in general, I highly recommend the website as a news source, and you should consider signing up for their weekly emails.