Medicaid cuts threaten the rights and lives of North Dakotans with disabilities
(Photo via Getty Images)
As executive director of The Arc of North Dakota, I've witnessed firsthand how essential Medicaid-funded services empower individuals with intellectual and developmental disabilities to live independently and engage fully in their communities. But today, that independence is under serious threat.
On Thursday, the U.S. House of Representatives passed the 'One Big Beautiful Bill Act,' which includes sweeping cuts to Medicaid. For many in North Dakota, these cuts aren't abstract figures. They mean losing access to critical services that make daily life possible, like bathing, commuting to work, or attending community programs, robbing them of their place within the community.
This threat to Medicaid is more than a fiscal issue. It's a rollback of decades of hard-won progress. In 1980, six North Dakota families partnered with The Arc to challenge the inhumane conditions at Grafton State School and San Haven State Hospital. That lawsuit led to the closure of San Haven, reduced the population at Grafton, and shifted our state toward more humane, community-based care. Now, that legacy is in danger of being erased.
U.S. House Republicans push through massive tax and spending bill slashing Medicaid
In addition to deep funding cuts, the legislation introduces policy changes that restrict access to care in multiple ways:
Work requirements: The mandatory Medicaid work requirements start date has been moved to Dec. 31, 2026. Although people with intellectual and developmental disabilities are technically exempt, real-life implementation often fails to protect them. Many individuals with disabilities and their family caregivers get caught in confusing eligibility rules, risking wrongful loss of coverage.
Increased costs: States can now charge Medicaid recipients up to $35 per service. Annual out-of-pocket costs could shoot up even for those near the poverty line, making necessary care unaffordable for many.
Frequent eligibility checks: Medicaid eligibility will be reviewed every six months instead of annually. For people with limited access to technology or help navigating paperwork, this change drastically increases the risk of losing coverage due to missed notices or simple errors.
Limits on provider taxes: New federal restrictions on provider taxes limit how states fund their Medicaid programs. This could reduce available dollars for crucial services, including supported employment, in-home care, and day programs. These services allow individuals with intellectual and developmental disabilities to live and thrive in their communities.
While it's difficult to pinpoint precisely how many North Dakotans with intellectual and developmental disabilities will be affected, the overall impact is clear: Medicaid is the backbone of their support system. Even if some individuals are exempt from specific requirements, the broader funding cuts and program restrictions will limit access, increase delays, and force many to go without the help they need.
Families are already facing long waitlists and strained service systems. These cuts will only make things worse. When services disappear, people don't just 'fall through the cracks'; they face real, lasting harm.
Consider one individual with intellectual and developmental disabilities who's waited months for a supported employment slot. Without a job coach, they remain unemployed, despite being ready and eager to work. Medicaid cuts push that opportunity further out of reach for them and hundreds of others like them.
And the alternative? Institutional care may sound like a backup plan, but it isolates people, limits opportunities, and costs the public far more. Supporting people in their communities is the right and the fiscally responsible choice.
At The Arc, we believe people with disabilities deserve the supports they need to live full, meaningful lives. But today, families and providers are navigating a maze of shifting rules, disappearing services, and uncertain futures. The confusion alone makes it harder to get help when needed most.
To pursue this direction is to court the resurgence of systems we consciously moved beyond. Our collective experience, however, and the resources now at our disposal, equip us to forge substantive improvements rather than reenact previous failings.
North Dakotans of all abilities deserve more than just survival. They deserve a future built on dignity, inclusion, and respect.
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
4 hours ago
- Yahoo
Senate parliamentarian rejects GOP's attempt to limit courts' contempt powers
The Senate parliamentarian has ruled against a controversial provision in the Senate Republicans' megabill that would have made it significantly more difficult for courts to enforce contempt findings against the Trump administration. The parliamentarian, Elizabeth MacDonough, ruled that limiting courts' ability to hold Trump officials in contempt violated the Senate's rules governing what can be passed with a simple-majority vote on the budget reconciliation fast track. Senate Democratic Leader Chuck Schumer (N.Y.) hailed the parliamentarian's decision as a major victory. 'Senate Republicans tried to write Donald Trump's contempt for the courts into law — gutting judicial enforcement, defying the Constitution and bulldozing the very rule of law that forms our democracy,' Schumer said in a statement responding to the development. 'But Senate Democrats stopped them cold. We successfully fought for rule of law and struck out this reckless and downright un-American provision,' he said. The provision, tucked into the thousand-page bill House Republicans passed in May, would have required anyone suing the federal government to pay a bond before a court would be allowed to use its contempt power to enforce injunctions and other rulings. Courts have already ruled more than 190 times against the Trump administration since January. The controversial language received little notice when it came to the floor, and Rep. Mike Flood (R-Neb.) later caused an uproar at a town hall meeting when he admitted he didn't know the provision was in the legislation when he voted for it. 'If enacted, this would have been one of the most brazen power grabs we've seen in American history — an attempt to let a future President Trump ignore court orders with impunity, putting him above the law,' Schumer said Sunday afternoon. 'Donald Trump is not above the law. And thanks to Senate Democrats — including the tireless work of Senator Durbin and the Judiciary Democrats — the courts can still hold him and any president accountable,' Schumer said, referring to Sen. Dick Durbin (D-Ill.). Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
4 hours ago
- Yahoo
KY Rep. Thomas Massie is at odds again with Trump over Iran. Here's the history
Kentucky Rep. Thomas Massie and President Donald Trump don't always see eye-to-eye. In fact, the two Republicans have been at odds for most of Trump's second term. Massie was one of only two House Republican 'no' votes on the president's massive spending bill, and he's been the loudest voice in the room against Trump's actions against Iran. And on Saturday, Massie led GOP opposition to the Trump administration's intervention in the Israel-Iran war by striking three Iranian nuclear development sites. Trump has repeatedly called the 4th Congressional District Rep. a 'grandstander' and said earlier this year he 'should be primaried.' The past few months are just the latest in a long history between Massie and Trump, though. The pair agree on many conservative principles, and have endorsed each other at points, but Massie's relationship with has been among the most frictional of any sitting lawmaker over the years. Here's a timeline: Massie, a critic of most precautionary measures adopted during the COVID-19 pandemic, forced an in-person vote on a Trump-backed relief package early in the pandemic in 2020. Members of both parties criticized Massie, and Trump called him a 'third-rate grandstander.' The president also urged Republican leaders at the time to 'throw Massie out of Republican Party.' Later that year, a GOP primary challenger's attempt to brand Massie as disloyal to the president fell far short of success. The challenger, Todd McMurtry, notched 19 percentage points to Massie's 81. During the next election cycle, Claire Wirth took a similar tack and lost by roughly the same margin. Shortly after Massie's primary win, Trump endorsed him for the general election, calling the representative a 'Conservative Warrior' and a 'first-rate Defender of the Constitution.' In 2023, Massie hitched his wagon to the GOP presidential primary campaign of Florida Gov. Ron DeSantis. The governor was viewed widely as the most viable Republican alternative to Trump. Massie made several out-of-state appearances with DeSantis before DeSantis withdrew from the race in early 2024. In May 2024, Massie trounced his two GOP primary opponents, including Eric Deters, a Northern Kentucky political figure who has hewed close to Trump. In October 2024, just 11 days before the general election, Massie endorsed Trump in his ultimately successful bid for president. One of Trump's first legislative priorities was a funding bill that averted a government shutdown. Massie was the only 'no' vote on the bill in March of this year, prompting Trump's call that he 'should be primaried,' and vowing to 'lead the charge against him.' In the midst of that scrum, former co-manager of the Trump 2024 presidential campaign Chris LaCivita posted a cryptic message on social media indicating he'd work against Massie. As of late June, a legitimate primary challenger has yet to be announced. On Trump's wide-reaching 'Big Beautiful Bill,' Massie was unflagging in his opposition, citing its likelihood of increasing the national deficit and not cutting entitlement programs like Medicaid as much as he'd like. Trump made a pitch to Massie face-to-face at a House GOP caucus meeting in May, and Massie was unmoved. Two days later, Massie was one of just two House GOP members to vote no on the 'Big Beautiful Bill.' Since the conflict between Israel and Iran has heightened in the last 10 days, Massie has been one of the leading anti-intervention voices on the American right. Trump has not responded directly to Massie's activism, which turned to stark criticism following the U.S. military strikes on Iranian nuclear sites Saturday. Massie has asserted that the administration needed to consult Congress before launching the attack, and last week introduced a resolution against U.S. involvement in the war. Massie joined his resolution's co-sponsor, California Democrat Ro Khanna, for an interview on CBS Sunday denouncing the strikes. He framed the aggression as going against a crucial part of the new Republican party that stands against foreign intervention, adding he believes it was 'a good week for the neo-cons in the military industrial complex who want war all the time.'
San Francisco Chronicle
4 hours ago
- San Francisco Chronicle
Americans react to US strikes on Iran with worry as well as support for Israel
BILLINGS, Mont. (AP) — One of Layton Tallwhiteman's earliest memories was watching the news at his uncle's house in Montana in 2003 and seeing the U.S. bomb Baghdad to launch the war in Iraq. Recollections of that war — waged in part to find weapons of mass destruction that did not exist – flooded back for Tallwhiteman after President Donald Trump ordered weekend bombing strikes on Iran's nuclear facilities amid its escalating conflict with Israel. The administration has indicated it wants to avoid getting pulled into all-out war. Tallwhiteman, who grew up on the Northern Cheyenne Reservation southeast of Billings, is skeptical. 'Their idea is to eliminate the threat. Like Bush said in Iraq, 'We're going to eliminate the threat. We're going to find weapons of mass destruction and eliminate them.' Did that work the way he planned? No, obviously it didn't,' said Tallwhiteman. The 30-year-old driver for a food distribution company said he usually votes Libertarian, but backed Democrat Kamala Harris over Trump last year. Across the U.S. on Sunday, Americans expressed a mixture of support, apprehension and confoundment at the bombings, which officials said caused severe damage to Iran's nuclear sites. Administration officials said the strikes left room for Iran to return to negotiations over its nuclear program. Yet if the conflict spirals, it could test Trump's foreign diplomacy skills and also his support at home. 'It had to be done' B-2 bombers that participated in the weekend strikes returned home to Whiteman Air Force Base in Missouri on Sunday. Nearby, retired Air Force veteran Ken Slabaugh said he was '100% supportive' of Trump's decision and the military personnel who carried it out. Slabaugh said Iran has showed resistance to negotiations over its nuclear program for decades, a problem that he said Trump inherited. Iran can't be trusted, Slabaugh said, nor allowed to acquire nuclear weapons. 'It simply had to be done,' he said of the strikes, adding that he's now concerned for members of the military around the world. 'I'm proud of the guys and the gals that are doing the work out there. Nobody in the world does this like we do, and we have the freedom and liberty we enjoy because of that,' Slabaugh said. In Rehoboth Beach, Delaware, Andrew Williams, 18, said he was surprised by the timing of the attack given that many Republicans had expressed opposition to U.S. involvement in the Israel-Iran war. Still, he thought it was necessary if Iran was building nuclear weapons. 'If we are able to get rid of that, that is something we should do,' Williams said. Robert Wallette of Billings said Trump had 'good reason' to conduct the bombing as a demonstration of American support for Israel. 'Iran's evil, evil people. They hate Americans,' he said. Concern about conflict spinning out of control Wallette, 69, a retired contract specialist at the federal Indian Health Service, said he hated Trump when the Republican was first elected because of his arrogant style. His perspective started to shift after Trump moved the U.S. embassy from Tel Aviv to Jerusalem. In 2024, Wallette voted for Trump based on his promises to curb illegal immigration, putting him among the 60% of voters backing Trump last year in Yellowstone County, which includes Billings. Notwithstanding his support, Wallette was unsure if Trump can avoid the U.S. getting drawn into a deeper conflict with Iran. 'Other countries are getting involved and this may be out of his control,' he said. Kent Berame, 32, of Davie, Florida, said it was a little outrageous for Trump to go rogue and approve the attack without explicit support from Congress. He said he doesn't agree with the United States supporting Israel's recent attacks on Iran. 'There's concern that we're putting troops in danger,' said Berame, a Democrat who owns his own marketing company. 'And obviously there's a retaliatory response toward all of our bases over there.' Berame said it's frustrating that the U.S. might be increasing hostilities with Iran just a few years after finally ending the war in Afghanistan. 'I don't want to see any U.S. soldiers in harm's way or in danger,' he said. Back in Billings, Trump voter Patty Ellman said she worries about the U.S. getting sucked into another extended conflict. 'We have enough going on in America to get into other countries' wars. Let's just take care of us right now,' she said. Ellman, a 61-year-old who stepped in as caregiver for her ex-husband after he suffered a stroke, said the U.S. should retaliate if attacked, but otherwise stay out of Iran's conflict with other countries. 'That's their business,' she said. 'We need to worry about Americans and how we're going to survive and are we going to have Social Security.' With contributions from David Fischer in Davie, Florida; Nicholas Ingram in Knob Noster, Missouri; and Mingson Lau in Rehoboth Beach, Delaware.
