We are proud to repost a column written by our friend and colleague Pat Nobbie. This post was originally published in the Georgia Council on Developmental Disabilities award winning quarterly magazine, “Making a Difference” in a column called “Mia’s Space” which Pat has been writing for the past 14 years. This month she takes a look at some of the costs around Medicaid. Enjoy the column and be sure to check out more from Making the Difference and GCDD.
People with disabilities and their families are forever in a defensive posture for defending the legitimacy of their need for Medicaid to provide health care and home and community based services so they can live in the same communities as everyone else. Believe me, those of us fortunate enough to have an HCBS waiver appreciate what a blessing it is, because with that support, we can live our lives. But families who have services are always on guard to protect them and families on waiting lists are continually advocating to get them. Quite often we can be made to feel guilty for using “government” resources that could be spent somewhere else.
We must be particularly vigilant now with an administration that is considering how to reconfigure Medicaid. The narrative, on a very basic level, is that somehow people receiving Medicaid are undeserving – too dependent, for too long, without justification. And some important distinctions are missing – Medicaid beneficiaries run the gamut between low income women and children, infants and toddlers with developmental disabilities, children to age 21 with special health care needs, children and youth in foster care, people with presumptive disabilities, people with acquired disabilities and older adults. Among this diverse population, is it helpful to characterize people as either “givers” or “takers” because of their need for public assistance?
What I want to share here is the economic contribution that someone like Mia, who has a Medicaid waiver and receives SSDI, makes to the economy.
Mia’s waiver pays two direct support people; one pays $225 in taxes on the income she makes from Mia every two weeks, and the other pays about $100 in taxes every two weeks; about $8125 annually.
Mia’s waiver includes supported employment; she has a job for 25 hours a week at St. Mary’s Hospital. She pays about $105 in state, federal, FICA and Medicare every two weeks, $2500 average per year on her income. Her waiver pays Briggs and Associates, the company that provides her job coach, $10,670 per year. Mia’s job coach pays taxes on her income.
A support coordination agency also gets paid $900 per year from her waiver.
Mia’s SSDI helps with her living expenses – utilities and groceries, approximately $7500 a year, and with her paycheck, she spends about $2500 a year on clothes, restaurants, movies, bowling, and swimming, on all of which she pays sales tax.
Her social connections and busy schedule keep her healthy, so Medicaid rarely gets billed for health care.
Because her waiver keeps Mia well – supported in the community, I can work at a good paying job. Last year, I paid $23,000 in state and federal taxes.
So let’s do the math. Mia returns about $32,000 to the economy, roughly 50% of the funding that she receives for her support. And this doesn’t include what her siblings or I can contribute from full time work, knowing she is well-supported. The benefit of her presence in the community is a bonus. Not a bad equation, wouldn’t you say?
Pat Nobbie is an accomplished disability advocate and is also a parent of a young woman with Down syndrome who lives and is employed successfully in the community in Athens, Georgia; as well as son and a daughter in San Francisco. To read Making a Difference Spring 2017, visit http://bit.ly/2qF74Us