Medicaid uncertainty
By: Gene Myers
NorthJersey.com
USA Today Network - New Jersey
..... Theresa Luoni starts her days at dawn in Basking Ridge, helping her twin 12-year olds sons get ready - brushing teeth, getting dressed, managing meltdowns. Max and Dylan are "profoundly" autistic and need constant supervisions, their mom said.
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"Although they're 12, they need to be watched like 3-year-olds," she said. "One wants to be inside, one wants to be outside. I'm constantly running back and forth."
..... Dylan, who is nonverbal, attends REED Academy in Franklin Lakes, a private school that specializes in educationist students with autism. He learning how to read, write his name, and recognize traffic signs. Max, who has significant behavioral and sensory challenges, is enrolled in ROOTS, an intensive all-day clinic in Cedar Knolls. He's currently out of a traditional school setting because he hasn't been able to tolerate being in a classroom.
..... "We"re starting over," Luoni said in an interview. "He's learning how to be in a group setting again so that, hopefully, he can return to school."
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The twins; placement are funded through Medicaid, the state-and federally-funded health insurance program for low-income Americans. Their mother worries that could be in jeopardy due to a Republican budget in Washington that calls for $625 million in Medicaid cuts.
..... The reduction would help pay for President Donald Trump's proposed tax cuts as well as increased military spending and immigration enforcement. The legislation survived key committee votes over the past week as House Republicans race to get it approved by Memorial day before sending the plan to the Senate.
..... "This would be the biggest cut to Medicaid in the program's history," said Andrea Ducas, vice president for health policy at he Center for American Progress, a progressive public policy think tank. The Congressional Budget Office projects that 7.6 million people could lose coverage under the House proposal, and up to 14 million could become uninsured when combined with other Republican policy proposals, she said.
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House Republicans say the changes would preserve Medicaid for its originally intended beneficiaries, the poorest Americans. many of their cuts are aimed at recipients who make just over the federal poverty line and were added to the program under the Affordable Care Act, also known as Obamacare.
..... Republicans noted that Medicaid enrollees with children and those with disabilities would be exempt from work requirements the GOP wants to impose.
..... "My colleagues and I just passed the single strongest Medicaid package in our nation's history that protects the needs of its intended beneficiaries," U.S. Representative Tom Kean, Luoni's congressman, said on social media after voting for the bill on May 12. [2025] "Our package makes common sense reforms to root out waste, fraud and abuse, so we can support and preserve the programs that thousands of New Jerseyans rely on."
..... Kean's office, through a spokesperson, declined to answer questions on the record about the proposed cuts.
..... About 1.8 million New Jersey residents are enrolled in Medicaid, including children, older adults and people with disabilities. Any significant changes to eligibility, funding or coverage could affect a wide range of services, form home care to school-based therapies and medical treatments advocates said.
How GOP budget would change Medicaid
..... Republicans are proposing several key changes:
New Work requirements: The bill includes work requirements for adults covered under the Obamacare expansion, those making up to 138% of the poverty threshold - currently about $22,000 for a single person and $44,000 for a family of four.
..... While there will be exemptions for people with disabilities and parents of dependent children - categories Luoni would likely fall under - Ducas said recipients would have to complete paperwork and be formally approved for the exemption, which could be hard for those who don't already have official disability status. "Even if you qualify, you still have to go through a process that can be very difficult, especially for caregivers under strain," Ducas said.
.....More paperwork, eligibility checks: The legislation would make enrollees re-certify their Medicaid eligibility every six months, rather than the current once a year, adding another hurdle when it comes to keeping coverage, said the Kaiser Family Foundation, a nonpartisan helaht policy analyst. It also would require stats to do more to prevent people from signing up in tow states at once, and to remove dead people from the Medicaid rolls.
..... Limits on emergency care: Medicaid currently covers health expenses for up to 90 days retroactive to when a recipient sings up, a provision that advocates say helps those need coverage during emergencies. The GOP bill would limit that to one month.
..... Pressure on state budgets: People with disabilities could also be affected if states are forced to cut spending to compensate for federal Medicaid losses, Kaiser said. State-funded benefits like personal-care aides or group home expenses aren't required by federal law and therefore could be in jeopardy.
..... "That what worries me," said Ducas. "When states face cuts, optional services like these are often the first to be affect4ed."
..... The Republican proposal also limits states' abilities to raise taxes to cover Medicaid expansion, and it cuts the amount the federal government will pay for states that choose to caver undocumented immigrant children.
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Congressional Democrats have unanimously opposed the GOP budget. Republicans said they were misleading the public by highlighting stories of children and people with disabilities, who the GOP says would not be affected.
..... Kean,m in his classic post, said the bill "stopped illegal aliens from stealing Medicaid while protecting children, the disabled, seniors and the vulnerable population who relies on it. Also, thanks to our work, New Jersey hospitals and nursing homes can deliver quality care to patients for years to come."
..... "I listened to the New Jerseyans I meet with frequently on issues such as Medicaid coverage. And today, [05/15/2025] I am proud that we successfully protected their care," he added.
..... More than 73,000 people in Kean's 7th Congressional District are enrolled in Medicaid, according to the Centers for American Progress.
What Medicaid covers
..... For Luoni, the stakes feel intensely personal. "Without Medicaid, I would have to choose whether i could eat or afford their health care," she said of her sons.
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She has tried to work, but full-time care-giving has made it nearly impossible, she said. "I've lost six jobs in the past two years trying to work and be a caregiver," she said. "I don't own a car. I was walking to work at 4:30 in the morning. If something happens at school or therapy, I have to go right away. There's no other option." She now rents a room in her mother;s house.
..... Luoni said Medicaid covers more than just medical appointments for her sons - it helps fund services like speech, occupational and physical therapy.
..... "People think we're getting luxuries. We're not. We're getting vaccines, eye exams, dental care, preventative care," she said. "It's what allows my kids to keep learning and live at home."
..... Max used to take off his clothes in public due to sensory issues, which made it hard to leave the house safely. Since beginning therapy at Roots, he's started wearing a wider variety of clothing and that has made it possible for the family to return to grocery stores, parks and the kids' programs.
..... Luoni has tried to raise her concerns with lawmakers, including Kean, whose district includes her home.
..... "I've been calling Representative Ken's office every day. I've sent emails. I've getting no response," she said. Earlier this year, [2025] she brought her sons to a protest outside his district office in Bernardsville. She also testified at the Statehouse in Trenton during a budget hearing.
..... "These programs are not extras," Luoni said. They're the reason my children can keep growing. Without them, they don't just lose services - they lose their future.
..... This story includes material from USA today