‘People will die’: What Medicaid cuts would mean for children with disabilities

Not long after Erin Gabriel gave birth to her daughter, Abby, doctors told the mother she would outlive her child.

As a baby, Abby faced a long list of health conditions. She was having trouble swallowing and feeding. Doctors soon discovered she was deaf, blind, medically complex, and autistic. According to what doctors told Gabriel, Abby would never communicate with her family or be able to walk.

That, however, has not been Abby’s story. Now 15 years old, the Beaver County resident can communicate — her mother calls her “the funnest kid you’ll ever meet” — is able to walk, adores Taylor Swift, and is a Disney aficionado.

These days, you can find Abby placing a speaker against her face so she can feel the music’s vibrations, going through the local car wash to which her parents have a membership solely because of how much their daughter loves it, and attending live shows — “Hamilton” is a particular favorite.

She’s a happy child who is rarely without a smile on her face, said Gabriel.

But Abby’s life could have been very different if she hadn’t had immediate access to Medicaid as a baby, her mother said. 

“Because she had this dream team of early interventionists, she can walk; she can eat,” Gabriel said. “She loves to eat. She can communicate in her own way. She understands sign language receptively.”

“She’s very social, and she does a lot of the things that people said she would never do, and that’s because she had access to Medicaid and early intervention, and, then, later on she had Medicaid paying for things like a one-on-one therapist who would go to school with her and help her navigate that whole environment and make friends with kids,” Gabriel continued. “It’s paid for a lot of the extra medical equipment that she uses.”

However, Gabriel is not sure now what her daughter’s future holds as congressional Republicans set their sights on cutting Medicaid, a public health insurance program that provides coverage for about three million Pennsylvanians, including children, pregnant people, and individuals with disabilities. In order to pay for President Donald Trump’s tax cuts for the wealthy and the mass deportation of immigrants, the Republican-majority House in February passed a budget resolution that calls for $4.5 trillion in tax cuts and a $2 trillion reduction in federal spending over the next 10 years. The plan instructs the Committee on Energy and Commerce, which oversees the Medicaid and Medicare programs, to cut at least $880 billion from its budget. 

That kind of cut to Medicaid leaves parents of children with disabilities fearing for their children’s lives.

“If they go through with these cuts, Medicaid will never be the same, and people will die,” said Gabriel, who’s also the government affairs representative for the Pennsylvania Health Access Network, a group that advocates for affordable health care for all Pennsylvanians. “And the people who suffer first and fastest are people with disabilities, seniors and kids, because that’s where the money gets spent.”

‘A very scary and dark future’

Following the news that congressional Republicans want to cut funding for Medicaid, parents described feeling despair over a world in which their children may be unable to obtain the support they need to live. It has been so stressful for families, Gabriel said, that she knows numerous parents who have gone to the hospital for chest pain caused by anxiety over the possible cuts.

“Imagine being told that you’re going to outlive your child, and make memories instead of plans, and how devastating that can be. And then imagine being told, actually, your child is probably going to outlive you, but instead of that being the glorious thing that it should be, it’s met with also a level of panic,” said Gabriel, who, in addition to Abby, has two other children with autism who use Medicaid. “What happens to her when I’m gone? And having these cuts looming makes that so much more terrifying.”

The parents who spoke with the Pennsylvania Independent said the proposed cuts to Medicaid could result in their children losing a wide range of health services not currently covered by their private insurance, including home aides and physical therapy.

As is the case for approximately 87,000 children with disabilities in Pennsylvania, Abby is covered by both private insurance and Medicaid due to the extent of care needed to treat her range of health conditions. Abby is able to remain on her parents’ private insurance through the age of 30. However, her mother asked, what happens if these cuts go through and her daughter isn’t covered by Medicaid and can’t be on her parents’ insurance?

“I don’t even want to think about what her future looks like because it’s a very scary and dark future without the help that she needs to stay at home,” Gabriel said. “I don’t want to think of my little girl as a 20-something-year-old, when she should be out to dinner with her friends or what have you, and instead she’s stuck in a hospital kind of setting because somebody decided to pull the plug on her services to pay for the things that they want to pay for instead. It’s very, very frightening.”

Toni Danchik, a Bethel Park resident whose 16-year-old daughter, Christine, is also covered by a combination of private insurance and Medicaid, said the proposed cuts to Medicaid could end in her daughter no longer having a paid home health aide. In addition to ensuring that Christine has the around-the-clock care she needs, having a home health aide also allows Danchik to work outside the house. Christine has Down syndrome, a heart condition that led to her needing open-heart surgery, and severe dual hip dysplasia that makes it necessary for her to use a wheelchair, among other medical issues.

“I mean, dear Lord, we were already stressed about her future and where we are in life. Add this to it – yeah, we haven’t slept,” Danchik said. “We talk about it all the time. It has consumed us, waiting to see if the ball is going to drop here. We are sick over it; it has really kind of taken over our lives because it’s really all we think about right now.”

April Chirdon, a nursing assistant at a nursing home in Cambria County, has a 10-year-old son with epilepsy; his Medicaid covers his daily medicine and hospital tests. If he needed an ambulance, Medicaid would pay for that.

“I would be in financial ruin if I did not have that Medicaid card for him,” Chirdon said.

‘There’s no way to cut Medicaid without hurting kids like mine’

Should congressional Republicans carve hundreds of billions of dollars from Medicaid, the cuts would “absolutely decimate” the nearly 60-year-old program that provides coverage to 79.3 million Americans, Gabriel said: “I don’t think that in four or eight or 12 years, when we have a new political dynamic, I don’t know that there will be the appetite to come back and invest so many trillions of dollars into Medicaid to fix what they’ve done.”

Republican lawmakers’ staunch support for Medicaid cuts is rejected by mostAmericans. Most American adults, or 82%, want to see Medicaid funding either increased or kept the same, according to recent polling by KFF, a nonprofit that researches and publishes about health policy. Just 17% of American adults want to see Medicaid funding decreased, according to the same poll. About two-thirds of Republicans want Medicaid funding to be increased or kept the same.

Both Gabriel and Danchik, and many other parents, have urged Pennsylvania’s federal lawmakers to fight the cuts, including at a Feb. 28 rally organized by Democratic state Rep. Dan Miller. Every House Republican from Pennsylvania voted for the budget resolution that included the $880 billion cut to the budget of the committee that oversees Medicaid, while every Democratic House member from the commonwealth voted against it. Gabriel said she is confident that Democratic Sen. John Fetterman won’t back the Medicaid cuts and called on Republican Sen. Dave McCormick to do the same. In interviews, McCormick has appeared to support the Medicaid cuts.

“In the terms of Medicaid, the focus, in my opinion, should be waste, fraud and abuse,” McCormick said in a March 5 interview with WJAC-TV. “And I don’t think any American wants their taxpayer dollars to be focused on waste, fraud and abuse.”

Federal data regarding waste, fraud and abuse in Medicaid is difficult to come by. A January 2025 report from the Center for Children and Families at Georgetown University’s McCourt School of Public Policy notes, “There are no reliable estimates of the amount of fraud against Medicaid, but there is one data source that provides visibility into who the bad actors are.”

That source, the Georgetown document goes on to say, is an annual report published by the U.S. departments of Justice and Health and Human Services. The Georgetown center analyzed the December 2024 report from the federal departments and found that fraud against Medicaid is mostly committed by health care providers, including pharmacies, ambulance service providers and durable medical equipment suppliers. The analysis found no Medicaid beneficiaries listed in the federal report.

“Fraud against Medicaid is mostly committed by providers — to crack down on fraud, Congress and the Administration should follow the money,” the Georgetown report says.

Teresa Miller, who served as Pennsylvania’s secretary of health from 2017 through 2021, said during a March 5 press call, “There are significant controls in place … to find and address fraud, waste and abuse, because it’s not in anyone’s interest for Medicaid dollars to be wasted or misused.”

Miller said an individual’s eligibility for the Medicaid program is checked on an annual basis, and the state verifies that individuals still meet income and asset requirements to remain in the program. The state Department of Health and Human Services and the offices of the inspector general and the attorney general perform regular audits and investigations into Medicaid fraud. The attorney general also prosecutes Medicaid fraud.

“To suggest that Congress can cut hundreds of billions of dollars from Medicaid by simply ferreting out fraud, waste and abuse, and that people won’t feel the impact of these cuts, is simply disingenuous,” Miller said. “It’s dishonest, and it’s ignoring the reality of how the Medicaid program works and the impact that it has on people’s lives. Medicaid is a lifeline for millions of Pennsylvania residents.”

Gabriel too said cuts to Medicaid would inevitably hurt those who need it the most.

“There is no such thing as a safe cut to Medicaid. There just isn’t,” Gabriel said. “There’s no way to cut Medicaid without hurting kids like mine. So I would ask them to stop, find the money somewhere else, but cutting Medicaid is not the way to go here, and people are going to die. And I just hope that it’s not anybody that I love, and I hope that it’s not anybody that the senator loves.”