More Than a Safety Net: A Social Worker and Special Needs Mom Talks the Human Cost of Medicaid Cuts

Q: Can you tell me about yourself and your family?

A: I’m Dr. Becky Pletzer. I'm a licensed clinical social worker in Alaska and the mother to two boys, Sloan and Sawyer. Sawyer, my 11-year-old son, has a very rare chromosome syndrome and moderate autism. As both a social worker and the mother of a child with special needs, Medicaid has been imperative, forming the foundation of my son's life trajectory and outlook.

Our [Medicaid] journey started over eight years ago when we knew, right before Sawyer turned 3 years old, that something wasn't right. We had genetic testing done and learned Sawyer has a very rare chromosome syndrome called 22q11.2 duplication. And most of the people who have this syndrome are on the autism spectrum with other co-occurring diagnoses, which is the case with Sawyer.

Q: How has Medicaid been essential to you and your family?

A: Having Sawyer be diagnosed at an early stage and having access to Medicaid — to help supplement the thousands of dollars of services his care requires each month — has been imperative to his growth. It means he can build the skills he needs to participate in everyday activities, like being able to take care of himself and converse with his peers, his therapists and his teachers.

It has meant the gift of language, communication and meaningful relationships, which we all need and desire as humans. I wouldn't know what to do without the services and the people — the professionals who saw him every day, sometimes 25 hours a week — who make sure he has the foundation to be an independent guy and become a contributor to our community.

Q: There are some false narratives about how many Medicaid beneficiaries don’t work or don’t want to work. But the majority do work or can’t work because they serve as primary caregivers, are in school or have a disability. Can you talk about those narratives?

A: In my clinical experience, there's often this assumption that Medicaid is like food assistance. But that’s really not the case. Medicaid pays for lots of things, including long-term care. It is the only insurance, sans a few rare ones out there, that actually pays for long-term care.

And long-term care can look like a lot of things. It may mean a nursing home, community services or teaching life skills to people who profoundly need assistance but want to live at home. I've worked with people like this, who wanted to live independently and have their own apartment. And I was able to help them live independently through Medicaid, saving the state millions of dollars it would have otherwise spent on a 24-hour, long-term care facility.

Sawyer’s care falls into this long-term care window. We have private health insurance, but like most of our insurances as Americans, it only covers so much or a certain amount of time. And he needed Medicaid to supplement the thousands of dollars it cost to get him the right therapies: occupational therapy, speech therapy and applied behavioral analysis. It costs upwards of $30,000 a month.

Some people ask me, “Why does your kid have to have Medicaid? You're a professional.” My private insurance paid what they could, but it was still short of thousands of dollars. 

And the services that Sawyer received through Medicaid are the reason that he can speak, have a conversation and joke around with you today. 

He is now able to communicate and express his needs. He went from eloping or having temper tantrums to being a human who can voice his autonomy, which is all that we want.

[Medicaid being cut] affects us all. This isn't just my story, this could be your story. This could be your neighbor’s story. And it's going to be ours eventually. If we all live long enough, we're all going to need that type of care. As a social worker, my story is two-fold; but this shouldn't just be about my son Sawyer and his needs. This is about our neighbors and our community. This affects all of us.

Q: If you had the chance to speak to a lawmaker who is considering cutting Medicaid, what would you say?

A: “I really wish you would spend some time with your constituents who are doing this every day, with professionals like me, who help your constituents try to figure out how they're going to live life.”

It is so difficult to understand why we would cut something that could propel people to invest their lives in Alaska, to hopefully create generations that want to stay here and do the same. I don't know why we would want to push more people away from participating in our community and in the future that Alaska could offer people.

These are people who are working hard — trying to raise families, be good neighbors, be good clinicians. I don't understand why we would intentionally harm people who just want to live their American dream.                 

The views expressed here are those of the individual author and do not necessarily reflect the views of the AHA