Shavonne Brathwaite is the Delaware operations director for Mosaic, an organization that brings awareness to issues that affect the lives of those with intellectual disabilities.
For decades, people with disabilities were kept apart from their communities and not given choices about their lives.
My organization, Mosaic, has always worked hard to change that. As a nonprofit serving nearly 5,000 individuals with intellectual and developmental disabilities, as well as other diverse needs, across 12 states and 750 communities, our mission is simple: to empower people to live their best lives.
As the state operations director for Mosaic in Delaware, I have the privilege of seeing this mission fulfilled every day. But ongoing conversations about Medicaid have cast a concerning shadow over our work.
Earlier this year, the U.S. Congress passed House Resolution 1, also called the “Big Beautiful Bill,” which outlined significant cuts to federal Medicaid funding over the next decade.
We’ve been assured that the people we serve — those with IDD — are not the intended targets. After all, this is the very population Medicaid was created to help. But let’s be crystal clear: These cuts will put Mosaic’s services on the chopping block.
When I speak with friends, neighbors and community members, I realize that many don’t grasp this threat. Even some family members and guardians of people we support don’t realize that the services their loved ones receive through Mosaic are funded by Medicaid. The complexity of the system is to blame, but that gap in understanding allows dangerous, oversimplified statements, like “these cuts won’t affect people with disabilities,” to be taken at face value.
I am called to speak up — not just because of my role but because it’s the right thing to do. I believe in loving and serving my neighbors. I will always stand up for the people Mosaic serves. These are real people with real needs, who deserve dignity, compassion and quality care.
Medicaid is a government-funded health insurance program. Medicaid funding comes from both the federal and state governments. When the federal government reduces its share of funding, the burden falls on the states to either make up the difference or face difficult choices about reducing or eliminating optional Medicaid-funded services.
At Mosaic, the services we provide are 96% Medicaid-funded. We rely on this funding to offer personalized, quality care.
Almost all of our services — from 24/7 assistance in group homes or shared-living settings to intermittent help with daily life — are classified as home and community-based services. These services allow people with IDD to thrive in their communities, holding jobs, making friends and having a real say in their own lives. They give families and aging caregivers the long-awaited exhale of knowing that their loved ones are safe and supported, which allows them to work and contribute to the economy, as well.
Here’s the terrible truth: Home and community-based services are considered “optional” services by the government, and historically, they are the first to be scaled back when states face federal funding reductions. Though they are “optional” on paper, they are absolutely essential to people with IDD and their families.
The reduction of funding isn’t just a potential problem; it will exacerbate an existing crisis.
Across the country, more than 500,000 people with IDD are already on waiting lists for HCBS. Wait times often stretch from several years to decades. This forces people with disabilities to go without the support they need or be forced into costly, isolating settings, like large, state-run institutions. For families, this places an unnecessary emotional, financial and physical burden on them.
We should be investing more in Medicaid funding, not cutting it.
Which brings me to my final plea: Please join me in advocating for the protection of Medicaid for people with disabilities.
Since the reductions were approved in HR1, we must shift our focus to defending this funding at the state level. We must help our state representatives see the value of HCBS for people with IDD.
Here’s what you can do today:
People with IDD want and deserve the same thing we all do: a chance to live a full, meaningful life.
Thank you for standing with me, for them.
Reader reactions, pro or con, are welcomed at civiltalk@iniusa.org.
