ACA repeal round 2 — disability advocates must be heard

With three dissenting Republican votes, Friday, July 28, 2017, became a watershed moment for the advocacy community that represents 59 million Americans living with disabilities. Those votes in the U.S. Senate effectively ended the first round of the Republican led effort to repeal and replace the Affordable Care Act (ACA). 

Over four decades ago, I never thought I would become a part of the disability community. With one routine visit to the doctor’s office and one short prognosis from a physician, I learned that I had a retinal degenerative disease and would live most of my life without the ability to see. But I unexpectedly gained access and insight into a community of 59 million Americans with disabilities, which includes one in two families and one in four women, and that continues to enrich my life every day.

My situation has taught me one thing above all else. When in doubt, we must fight. That’s why I proudly served in the Obama administration as a member of the National Council on Disability and why I continued that work as a member of Hillary Clinton’s historic campaign last year. Simply put, the quality of life of so many Americans depended on our work.

That’s also the reason, despite a tough loss on election night last year, I decided to keep fighting through our disappointment. Many Americans living with a disability like me have joined me in that fight. Two months ago 64 disability rights advocates were jailed in the fight to stop repeal and replace of the ACA.

Millions of Americans across every demographic — all ages, races, socioeconomic status, religions and sexual orientations — stood up to protect our health care. But it was the disability community that blazed the trail and we were recognized for leading the effort. We led the battle and refused to be silenced, and now we need to step up again. 

We knew the summer fight over repeal and replace was just round one. The new proposal from Republican Sens. Bill Cassidy (La.) and Lindsey Graham (S.C.) is another attempt to repeal the ACA without a viable alternative to support the Americans it has brought under its protection.

The Cassidy-Graham legislation removes key ACA protections and includes $215 billion in federal spending cuts with the majority coming from Medicaid. These cuts would penalize states that have higher costs and provide more benefits to low-income residents, and especially hurt states adopted Medicaid expansion under the ACA. Simply put, states that expanded Medicaid under the ACA would lose funds while non-expansion states would gain funding.

The bill aims to shift the decision on how health care should be run to states, once again allowing states to opt for waivers that would allow them to charge people with pre-existing conditions more than others, which was prohibited under the ACA.

We must remain vigilant, not just on health care, but other issues as well.

Congress is already debating the budget for fiscal 18 and we know that President Trump and his administration are planning a big push on tax reform. The president and the Republican leadership in Congress have made it clear that they prioritize tax breaks for the wealthy over the health care needs of Americans living with disabilities like me and so many others.

Look no further than the fact that they attempted to include in a tax cut in the previous repeal and replace legislation that would have supported the richest one percent — those making $578K or above.

This is why we cannot rest — this fight is just beginning. The disability community must be just as present and engaged on these issues as we were over repeal and replace over the summer.

Americans with disabilities are a powerful force to be reckoned with — an estimated 35 million eligible voters and more than 62 million if you include those who have a household member with a disability. Just as powerful as those arguing about access to guns, reproductive rights, the environment, business regulation and so many other important issues — we must be considered and included when our elected leaders are making policy. 

We must build on every victory and gain ground every day to continue fighting for inclusion and pushing back against anything that will impede that progress. Protecting this progress sends a message — our community is strong, and we are not afraid to face and conquer challenges, in our everyday lives and in legislative battles.

It is clear that the repeal and replace effort is far from finished, but this could be Republicans’ last formal effort for a while if it fails. Those trying to destroy the ACA to fulfill campaign promises and decimate Medicaid will continue to look for avenues to make that happen. However, each time they swing, the disability community needs to be there to swing back.

Janni Lehrer-Stein, served two terms on the National Council on Disability (May 2011 – Dec. 2016) and was a Senior Domestic Policy Advisor to Hillary for America. She was progressively blinded by retinal degenerative disease in 1982 and has been a disability rights advocate for more than 30 years.