Waiting for news of the GOP’s Medicaid cuts is like ‘staring down the barrel of a shotgun’

Here’s a moral dilemma we should present to every Sunday school class in America:

You’re facing pressure from your wealthy boss to provide tax relief for people who can afford fleets of private jets, but in order to do so you must eviscerate a program that’s keeping some of your most vulnerable neighbors alive and prevents others from lying in their own excrement. You must make a decision that aligns with the values you profess. In the case of the Sunday school class, that means your faith.

Congressional Republicans, many of whom make a big show of their public prayers and Christian credentials, have faced this very dilemma. Their decision is causing more than a bit of unease among people such as Michael Haider.

“I wake up in the morning staring down the barrel of a shotgun,” he said. “It isn’t any fun.”

Michael, 39, has cerebral palsy with spastic quadriplegia, which affects all four of his limbs, and uses a wheelchair. He’s one of 15 million people with disabilities who rely on Medicaid. That’s about 2 million people greater than the population of Pennsylvania. The number of billionaires: 756 as of 2024. Michael is not among them.

The anxiety caused by the GOP’s lust to ax $880 billion from the committee that oversees Medicaid was on full display several days ago, at a Downtown rally where several elected leaders and advocates blasted the Republican efforts. A few days later, I called Michael.

I’ve known Michael for years. We talk by phone several times each week and sit side by side on Sunday mornings at a small table to manage the audio and camera systems for our church’s livestream operation. Michael is concerned about where things are headed. When he speaks about looming cuts, his voice rises in anger.

“Without long-term services and support, I don’t get my clothes on,” he said. “And that’s fundamental to being a human.”

After talking to Michael, I reached out to Libby Powers, 37. Libby has spina bifida and a host of other physical challenges. Like Michael, she uses a wheelchair to get around. I first met her when she was a 4-year-old student at D.T. Watson Rehabilitation Hospital, where my wife, Brenda, worked as an occupational therapist. Brenda taught Libby skills such as carrying a lunch tray and gripping a pencil — skills she’d need as she prepared to enter public school. Brenda and Libby developed a bond that continues to this day.

Libby said the looming cuts to Medicaid are “causing collective trauma to a population that’s already vulnerable.” She then repeated something we’d heard others say at the Downtown rally: The GOP’s plan will kill people. “How?” I asked.

“People won’t have the attendant care they need,” Libby said. “They won’t be able to get out of bed. If they can’t get out of bed, if they can’t have somebody to physically turn them in bed, then they’re more susceptible to bed sores, and they’re more susceptible to infections that can kill them. So people are going to die. It sounds dramatic, but I’m not being flippant, and I’m not being unreal about this.”

The cuts, she said, “could completely decimate our population.”

Michael was equally blunt: “We’ll be stuck in our own bed, stuck in our own filth. That’s something people don’t want to think about, but it will happen.”

He closely follows the actions of Elon Musk’s DOGE squad and its potential effects on everything from Social Security payments to weather reports to airport safety.

“I really do fear we’re in for a wholesale collapse of our government, and nobody is prepared for what that means,” he said. 

The actions of the folks in the so-called Department of Government Efficiency belie any thoughtful plan. They fire federal employees en masse, then scramble to rehire workers after discovering they perform essential tasks, such as securing our nuclear arsenal. This would embarrass most CEOs. Not Musk. He dances in the White House while bragging about the thousands he’s thrown out of work. The former head of the Social Security Administration is saying the DOGE firing of 7,000 agency workers will collapse the system that millions rely on. People won’t get checks. His advice: start saving now.

“There’s no backup plan for any of this,” Michael said. “It’ll be every man for himself.”

It’s not too late to stop the destruction. A battle certainly looms. But who’s going to do the fighting? Congressional Democrats who held up signs of protest at President Donald Trump’s joint address to Congress last week? One voice did rise in loud defense of those threatened by Medicaid’s destruction — Rep. Al Green, a Texas Democrat. But he stood alone and was then censured, with the help of 10 of his Democratic colleagues. It doesn’t inspire much confidence.

“We don’t have a buoyant Democratic party,” Michael said. And that doesn’t bode well for the future. “Once these cuts happen, they’ll be permanent. There will be no political will to return it to what it was. That’s exactly what the Republicans are banking on. Democrats will be too cowardly to fix any of this.”

The disabled community isn’t waiting for a savior. Its members, including Michael and Libby, are gathering in Zoom meetings and developing plans to push back. You can hear a bit of a sigh in their voices when they talk about this. Maybe it’s frustration. This isn’t their first trip into the cage match that’s D.C. politics these days.

In 2017, they mobilized to protest a Republican health care bill that threatened to slash Medicaid. Dozens of advocates, many in wheelchairs, jammed the hallway outside the offices of then-Senate Majority Leader Mitch McConnell. Police dragged folks away and placed them under arrest. In Pittsburgh, Libby took part in a “die-in” that blocked traffic in front of then-Sen. Pat Toomey’s Downtown office. Those efforts worked, but American politics has changed. Empathy is out of vogue. Punching down is in.

It’s a political movement that caught traction years ago. Remember that infamous video of Trump mocking a disabled reporter? More recently, we’ve read reports from a Trump relative claiming the president once said some people with disabilities should just die.

“If it were up to Trump, we wouldn’t exist,” Libby said. “Our subset of the population would be completely gone, and he would be thrilled with that.”

Michael bristled a few days ago when he read a story about a list of words the current administration considers “woke” and therefore worthy of purging. “Disability” and “disabilities” were among them. 

The list is long and includes words such as “transgender,” “Black,” “women,” “climate crisis.” Their removal is part of the administration’s war on diversity, equity and inclusion, which Trump and his supporters claim elevates people of color, women and the disabled over others the administration claims have more “merit.”

All of this sends a message to Michael.

“They don’t care if we die,” he said. “There’s a word for that. It’s called eugenics.”

Another word — this one is chilling to anyone who’s read a few history books.

A century ago, a lot of powerful people were talking about eugenics, the theory that populations can, and should, improve themselves through selective breeding. Libby minces no words in her definition. Eugenics, she said, is “the genocide of individuals who are in a marginalized community.”

Nazis embraced the idea and used it to justify death camps and forced sterilization.

“The real fear among our population is that we’re going to go back to putting people in institutions,” Libby said. That’s one consequence of living as a marginalized person in a society that says your life has no value.”

Michael lives with his parents in Kilbuck. His mother is paid to be his caretaker because he can’t find anyone else who will do the job for the low pay. Staffing for him has been an issue for at least a decade, he said. That’s just one problem with the current Medicaid system. Then there’s the mountain of paperwork applicants have to deal with, and the rules that tie benefits and income, thus trapping aid recipients in poverty. “We all understand the system is broken,” Libby said. “We still need it. It’s a lifeline.”

Libby was born in Korea. Her family adopted her when she was an infant, and she grew up as the youngest of six siblings, an experience that taught to be an advocate for herself.

“I learned from a very young age if I wanted to be heard or get what I wanted, I had to be loud,” she said.

She now lives in a Sewickley apartment, which places her close to her mother. Libby treasures her independence. She learned at a relatively early age to manage her own affairs. Libby’s father died suddenly when she was 19 years old and she weeks from beginning her first semester at Edinboro University. She’d been looking forward to being on her own, but the jarring loss of her dad caused her second thoughts.

“The thought crossed my mind, ‘Do I stay home? Do I help support mom?’” Libby said. “But she encouraged me to go. She said, ‘I don’t want you to stop just because dad’s not here.’ And so I went, and it really helped me to stand on my own two feet.” 

It wouldn’t be easy. Her father’s death meant the loss of health care. Libby had to figure out the complicated and burdensome paperwork required to receive government benefits. 

“I did it on my own because my mom was grieving the loss of her husband and my older siblings were living their own lives,” Libby said. “I had to make a lot of big decisions on my own. Before, my dad took care of all that stuff.”

After graduation, she went to work, which allowed her to get off of government services. Her most recent job was with a medical equipment company. She spent her working days interacting directly with patients, making certain they had the medical supplies they needed, and helping others to navigate the Medicaid system. If there was a problem, Libby helped solve it.

But her own health issues caught up with her. In addition to spina bifida, Libby deals with a condition called gastroparesis, which causes a host of symptoms like abdominal pain and bloating. She deals with this daily, and the symptoms worsen as she ages. This made it difficult to concentrate on her work, and this wasn’t fair to those who depended on her.

“It wasn’t until very recently that I realized doing a 9-to-5 job was not feasible for me anymore,” she said. “My body just doesn’t tolerate it because of my disabilities.

And so I had to make a decision. I had to just let it go entirely.”

And so now she’s back on Medicaid, which places her in Republican crosshairs.

It’s a lot to take in for people such as her and Michael and millions of others for whom life already poses enough challenges. Why are Republicans trying to make things even harder? Even with government benefits, most people with disabilities live on about $800 a month, Libby says. 

“Disability isn’t a choice,” she said. “I didn’t ask to have spina bifida. It just happened. So now we are being punished for doing the best that we can in a society that’s already not made for us.”