THIS TIME ON CODE WACK!
As a consequence of Trump’s drastic cuts to Medicaid and other health programs, experts estimate that between nearly 8 million and 10 million more Americans will be uninsured by 2034. These include the most vulnerable among us, people who depend on Medicaid because they are poor, ill and/or live with disabilities. And here’s the kicker: experiencing disability isn’t as rare or improbable as we’d like to think.
That’s why this fight for health care is about all of us—our families, our neighbors, and our future. From hospital care to home-based services to keeping rural clinics alive, Medicaid is a pillar of our healthcare system—and when it’s weakened, entire communities feel the impact. So what happens when that pillar is damaged? We recently spoke to Andy Imparato, executive director of Disability Rights California, and policy analyst Sabrina Epstein. This is the second episode in a two-part series with Disability Rights California.
Check out the Transcript and Show Notes for more!
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SHOW NOTES
WE DISCUSS
To help us understand the impact of Trump’s healthcare policies on the disability community, can you tell us the percentage of people who will actually experience disability in their life?
Epstein: “It’s just over one in five people I think is generally what’s cited how to measure disability and what counts is always an interesting question that many data scientists are working on. But yeah, between a fifth and a quarter of the population will experience disability at some point in their lives. And that means everyone knows someone with a disability. So this affects all of us.
Imparato: “And Sabrina, do you know … the percentage of Californians that are on Medi-Cal or like the percentage of mothers who have babies where the baby is on Medi-Cal?
Epstein: “So about … 38% of [California’s] population is on Medicaid, almost 15 million Californians. And then I think this statistic is nationwide, 40% of births are on Medicaid.”
Imparato: “So if you think about those numbers, Medicaid is a huge foundation on which access to healthcare is built in California. And … and in other states.
“So to the extent that the Republicans who passed the bill think that, ‘Well this is just about getting rid of the people that Obamacare brought in or Biden brought in,’ it just doesn’t make sense.
Some of those people are folks with disabilities, but you’re also really disrupting the foundation that allows rural hospitals to exist, that allows the specialty clinics … to exist. And it’s gonna be very hard to fix that. If we allow it to get implemented again, we can try to fight it and repeal it, but if this all gets implemented, it will be very hard to undo.”
So where will people turn? Are there any other options for them?
Epstein: “In most circumstances, no.
Imparato: “I mean, it also depends a lot on what kind of family support you can fall back on. If you have a family that’s willing to provide the care, that’s your option. It’s not paid, you know, but then that knocks that family member out of the labor force.
“And it has kind of ripple economic effects, but there are a lot of people that don’t have that. And you know, one of the outcomes for some people is being homeless, you know, being unhoused, showing up in emergency rooms. I mean, you know, we’re going to have a lot of desperation as the safety net gets removed.””
What about the impact of work requirements on Medicaid beneficiaries?
Imparato: “Well, if you look at the state that’s kind of most aggressively implemented work requirements in Medicaid, it’s Arkansas and there were a lot of people that lost coverage in Arkansas. And if you look at one of the reasons they wanted these work requirements in the bill is because it had a score that it was gonna save a lot of money.
“Well, how does a work requirement save money? It saves money by people getting kicked off of Medicaid.
“So … the expectation is that people are not gonna be able to do what they’re required to do. They’re gonna lose coverage and then the government will save money. But nobody seems to worry about the fact that this person doesn’t have healthcare anymore.
Epstein: “Like Andy said, the way all of those were scored was by disenrolling people. So saying you own a home that’s appreciated in value since you bought it 50 years ago, therefore you don’t qualify anymore. Or saying you can’t afford your copay, so you’re going to go without care or you’re going to avoid care unless it’s an emergency.
“All of these are just ways to either cut people from coverage altogether or have them using healthcare less frequently. It’s a terrible outcome. We want to spend government money on giving people healthcare. That’s a great way to use our tax dollars.”
Helpful Links
What the One Big Beautiful Bill Act Means for People with Disabilities, Disability Advice
Millions will lose Medicaid under Trump’s tax law. Here’s the final tally, USA Today
No Place to Hide: Children Will Be Hurt by Medicaid Cuts, Manatt Health
Medicaid Cuts Will Hurt Some States More Than Others—See How Yours Compares, Investopedia
5 Key Facts About Medicaid Work Requirements, KFF
New Evidence Confirms Arkansas’s Medicaid Work Requirement Did Not Boost Employment, Urban Institute
California Medicaid (Medi-Cal) Income & Asset Limits for Nursing Homes & Long Term Care, American Council on Aging
Episode Transcript
Read the full episode transcript.
Guest Biographies:
Sabrina Epstein
Sabrina Epstein (she/her) is a Policy Analyst at Disability Rights California. She works on issues that affect people with intellectual and developmental disabilities, including health care and housing. Her policy work is informed by her experience as a disabled person.
Andy Imparato
Andy Imparato is a disability rights lawyer and policy professional who has been working inside and outside government to advance policies and practices to improve employment outcomes for people with disabilities for over 30 years. His perspective is informed by his lived experience with bipolar disorder. He is the Chief Executive Officer of Disability Rights California, a $51 million legal services and policy advocacy organization based in Sacramento with 25 offices across California. Since 2024, he has served as the chair of the National Disability Advisory Council for Centene, a fortune 50 healthcare company. He has been an advisor on disability inclusion and accessibility to a number of other large businesses, including Walmart, Verizon, AT&T, Microsoft, IBM, Walgreens, and SAP.
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