Medicaid is a joint federal and state program that provides health insurance and access to long-term care to more than 2.6 million people in North Carolina, including North Carolinians with disabilities.

In North Carolina, there are an estimated 200,000 people living with an intellectual or developmental disability (IDD). People with IDD represent an array of conditions, including but not limited to, autism, Down syndrome, cerebral palsy, Williams syndrome, and Fragile X syndrome.

Most people living with IDD rely on Medicaid, as it is the primary health insurance for people with disabilities. Medicaid provides the means for home and community-based services (HCBS), direct support professionals (DSP), prescriptions, medical equipment, and assistive technology. HCBS includes day programs outside of the home, employment training programs, respite for caregivers, and educational activities that include learning how to create a budget.

The Arc of North Carolina is a statewide organization providing supports and services to over 5,000 people with IDD. Our staff have numerous success stories, not only about the people with IDD they serve, but their families as well.

The US House Budget Committee recently proposed, on Page 30 of their budget resolution, a per capita cap for Medicaid for each state. These caps would most likely not get North Carolina the funding needed for all Medicaid recipients and programs.

Medicaid is key to people with IDD living productive lives in the community of their choice. A loss of funding to this program would not only upend the lives of people with IDD and their families, but it would also harm North Carolina’s economy.

If a person with IDD loses access to supports and services due to cuts in the Medicaid program, some of the ripple effects include:

Employment: Many people with IDD are employed. A loss of funds could close supported-employment programs. It could also mean funding isn’t available to pay for the DSPs. If a DSP is not able to help, parent(s) may have to quit their jobs to stay home full time to take care of their child. All these scenarios result in a negative compounding effect in economic losses.

Increase to NC Innovations Waiver waitlist: North Carolina already limits HCBS due to constraints on available funding, with 18,771 people with IDD are currently on a waitlist to receive Medicaid-funded HCBS.

State budget: State legislators would have to look at making up for the loss in federal funds.

Shutdown of rural hospitals: Many people with IDD living in rural parts of North Carolina need access to rural hospitals for emergency care. Medicaid funding enables rural hospitals and other critical health care infrastructure to stay open and provide care.

Community based organizations: Organizations providing HCBS may have to furlough staff due to cuts in HCBS funding.

Loss of independence: Without supports in place, people with IDD may be forced to move into an institution and out of their community.

There is also great concern regarding the people living in western North Carolina who rely on Medicaid. Months after Hurricane Helene decimated parts of our state, people with disabilities are struggling to get basic needs met every day and a loss of Medicaid supported services would be devastating.

Medicaid allows people with IDD to live healthier and more fulfilling lives. It helps to support several facets of our state’s economy. Cuts to the the Medicaid programs they rely on would create chaos for people with IDD and their families, as well as the staff providing those necessary supports, and lead to increased unmet needs. We need improvements to be made to the Medicaid program, not cuts.