By Stephanie Murray and Stephanie Innes, Arizona Republic
Cave Creek resident Mary Pat McKenna is watching with bated breath as Republicans get closer to sending major Medicaid cuts to President Donald Trump’s desk.
The 68-year-old McKenna is worried because two of her four grandchildren were born with special needs. Her grandson Max received life-changing brain surgery when he was 5 years old to treat his cerebral palsy.
And Alexandra, her granddaughter with rare Pitt-Hopkins syndrome, just began taking her first unassisted steps at 10 years old with the help of extensive therapies.
Both children rely on programs funded by Medicaid to get the health care they need, said McKenna, who is their part-time caregiver.
“If it goes away, then there will be regression,” McKenna said. “I can’t even put into words how that makes me feel.”
McKenna is among the Arizonans who care for their disabled relatives and are panicked about what a Republican megabill on the move in Washington will mean for the future of Medicaid.
The One Big Beautiful Bill Act would make deep cuts to social programs such as Medicaid to offset making Trump’s 2017 tax cuts permanent. It passed the Senate on July 1 and contains countless new policies, from creating a tax deduction for tipped employees to authorizing billions in new spending on immigration.
“This is a big win for the American people,” said Vice President JD Vance, who cast the deciding vote in the Senate. All Democrats voted against the bill. Several Republicans crossed party lines to oppose.
Disabled community ‘will take the hardest hit’
The cuts to Medicaid are significant: 360,000 Arizonans could lose their coverage over the next decade, according to one analysis. Nationwide, 13 million people could lose their health insurance.
“I cannot overstate the damage heading Arizona’s way as a result of the cuts included in this Senate bill,” said Jon Meyers, the executive director of the Arizona Developmental Disabilities Planning Council. “All of Arizona will suffer, but the disability community will take the hardest hit.”
That’s caused Steve Furman to worry. The 69-year-old Scottsdale resident takes care of his adult son, Julian, who is 43 and has autism and epilepsy. Furman spoke to The Republic with his wife and Julian’s stepmother, Mary Beth Furman.
Due to his disability, Julian has struggled to find work, and Furman said he fears new work requirements and funding cuts could lead Julian to lose access to Medicaid.
Furman is concerned about how Julian will pay for his care or navigate the job market after his parents die. Julian worked for 15 years at an eyeglass frame manufacturer but has struggled to find employment or land job interviews in recent years because of his disability.
Furman said that Julian asked him recently: “Dad, who is going to help me when you’re gone?”
“I’ll be 70 this year. There’s a timeline, right? Who knows what’s going to happen with our finances, and our investments, and how long I’ll live, and how much money we’ll have to take out, and how much is going to be eaten up by an economy that’s ever-changing. We worry about that in the long run, when we’re gone,” said Furman, who is retired.
When Julian had a health scare, Medicaid and Social Security covered his hospital bill, ambulance bill and lab results. It was a “huge safety net” for their family, Furman said.
‘Where is that money going to come from’
Medicaid primarily provides health insurance to low-income people and people with disabilities. In Arizona, roughly one in four residents uses the program, which is called the Arizona Health Care Cost Containment System.
Annual funding for AHCCCS is $21 billion, a sum larger than the $17.6 billion state budget that lawmakers passed at the end of June. Only $2.7 billion of AHCCCS funds come from Arizona’s state general fund. The rest is covered by the federal government.
After the Senate bill passed, Arizona Gov. Katie Hobbs, a Democrat, warned the state cannot cover the cost of the Medicaid cuts, even if officials dipped into the $1.6 billion rainy day fund.
“Where is that money going to come from when the federal government takes it away?” asked Linda Somo, president of the Arizona Alliance for Retired Americans.
Senate Republicans narrowly passed the Big Beautiful Bill on July 1 after an all-night voting marathon. The legislation heads next to the U.S. House, where lawmakers will have the final say on the Senate’s changes to the bill.
Trump is pressing Republicans to send the bill to his desk for a signature by July 4, but some House Republicans are skeptical that the process will move so quickly. The bill will “probably not” land on Trump’s desk by that day, Rep. Andy Biggs, R-Arizona, said on Phoenix radio station KTAR.
Timeline aside, Arizona groups that advocate for people with disabilities are bracing for Medicaid cuts to become law. The changes could impact Arizonans who receive services through the state Division of Developmental Disabilities, which is funded in part by federal Medicaid funds.
“If we see cuts to Medicaid, then we do have concerns about people seeing their individual services through the Division of Developmental Disabilities being reduced or cut,” said April Reed, the vice president of advocacy at Ability360, a nonprofit for people with disabilities.
It’s difficult for Tucson resident Brandy Foster to even think about a scenario where her daughter’s Medicaid-funded caregiver would not be available.
Foster’s 21-year-old daughter Alexa has autism, is nonverbal and has physical impairments that cause problems with daily activities such as showering and eating.
A caregiver funded by Medicaid as a community-based service through the state’s Division of Developmental Disabilities spends about 30 hours per week in the Fosters’ home, and has been able to provide continuity in Alexa’s life, as well as help the family with issues that had been challenging, Foster said. Alexa has had the same caregiver funded through Medicaid for nearly six years.
Alexa’s caregiver has taught her how to take her medicine, has helped reduce the number of Alexa’s meltdowns from near daily to once or twice per month, and takes her on outings in the community that Alexa enjoys, her mother said.
“I’m really concerned about what those cuts could mean for us. I dread to think what would happen if we were to lose Anna (the caregiver),” Foster said. “The things Anna does for Alexa are not frivolities. … Without Anna and with just me, I think we would spend most of our time at home. It would really shrink Alexa’s world quite a bit.”
Foster has health challenges of her own. She has a form of muscular dystrophy that makes it difficult for her to stand for long periods of time, which is another reason why Alexa’s caregiver is so critical to their family.
Like other parents of kids with disabilities, Foster wants to keep her daughter out of group homes or institutions where she believes Alexa would be at a high risk for abuse.
Tucson resident John Raymond, a 75-year-old retired truck driver and former police officer, uses a Medicaid plan for people with special needs. His lower right leg was amputated after he faced complications from a motorcycle accident. Raymond, who was T-boned by a city bus, wears a prosthetic.
Raymond estimates that if he lost his access to Medicaid, he’d need to use an HMO plan and pay between $2,400 and $2,500 out of pocket for health care each year. Raymond doesn’t think he can afford it.
“How am I going to get the medical treatment I need?” Raymond said. “I’d have a choice, pay for the medical and be homeless or have a home and not pay the medical. And eventually, it would get to the point where they would come after me to get to pay for the medical.”
The high cost of health care is top of mind for McKenna, the grandmother from Cave Creek. Her 9-year-old grandson will need surgery on his Achilles tendon next year to provide more flexibility in his foot, which is affected by his cerebral palsy. If he loses access to Medicaid, his parents won’t be able to afford it even with the health insurance they get through an employer.
McKenna said she’s not only worried for her own family’s future if the Medicaid cuts become law. She pointed to the nearly 2 million Arizonans who use Medicaid and said that she’s frustrated that lawmakers are choosing to “take from the least” and “give to those who have the most.”
“There are so many vulnerable people,” McKenna said. “I sit here with my mouth open, going, ‘What are they thinking?’”
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