Disabled Texas Woman May Lose Coverage and Home From Medicare Cuts

“I've worked hard. I'm to the point where I own my own house,” says Nancy Crowther, 67, of Austin, Texas. “I have [attendant] services, and to lose that would be to lose my livelihood and to be desperately placed in an assisted living or something.”

Although she has spinal muscular atrophy, a progressive muscular disease with no cure, Crowther remains socially active and fiercely independent. She’s thrived for years beyond everyone’s expectations, she says, and chalks it up to her Medicaid home-care attendants, who help with daily necessities she cannot do on her own — and which she risks losing if Congress passes historically large cuts of $625 billion from Medicaid. The Senate is working through the weekend to pass its version of the spending bill in order to meet Pres. Trump’s stated goal of signing it into law by July 4.

Crowther is one of 70 million covered by Medicaid, and she’s also someone who has publicly told her story for decades to help score wins for the Texas disability community and the attendants who care for them. Now that the U.S. House passed its bill that would cut 13.7 million off of health insurance, Crowther is using her voice to call senators to tell them what Medicaid does for her — and urging others to join her.

(Above, radio version of story, from The People's News, KPFT-FM Houston, May 22, 2025.)

“{Medicaid] involves so many programs for young, for old, for different types of disabilities. It’s just a multiuse tool and if you start losing pieces of that tool, that's part of your independence that you’re losing,” she says. “Our lawmakers don't even understand that.”

Medicaid is the primary funder for home- and community-based services to keep seniors and people with disabilities living in their own homes with families and caregivers, instead of in institutional care like nursing homes that are more costly to taxpayers. These popular attendant-care programs already have waiting lists for enrollees in states across the country, and with current plans to shift Medicaid costs away from the federal government onto the states, with fewer resources, “usually, historically, the first [programs] on the chopping block are those home- and community-based services,” according to Jason Resendez of the nonprofit National Alliance for Caregiving. Losing her independence this way would be Crowther’s worst-case scenario. “The lowest thing on the totem pole would have to be an institution,” she says. “That would just be the death nail.”

In the House bill, the savings only partially fund $3.7 billion in tax cuts, the largest share of which going to those with the highest 10% of income. The bill would add $2.4 trillion to the national debt, not counting adding interest on that debt.

Crowther discovered the power of her voice years before the Americans with Disabilities Act, in the 1980s. She got involved in the movement to make Austin public transit accessible not only for people with disabilities, but also seniors and families with strollers. Since then, she’s been awarded for her groundbreaking work and has continued speaking out across her state of Texas, sometimes sharing her personal story with policymakers, or being the only disability perspective present at a meeting or serving on an advisory board.

Crowther was part of the push that moved the Texas legislature to boost wages for attendants who care for the disabled and seniors in 2023. Last month, members of her group, ADAPT-Texas, were among 300 wheelchairs users and supporters who packed the U.S. Capitol. Twenty-seven were arrested for bringing a House committee hearing to a halt, demanding they not touch Medicaid. This week, Crowther encourages fellow Texans to call their U.S. senators and relate their own stories and those of families and friends to whom Medicaid is important.

“It really fills you up with a sense of boldness, strength and compassion because you've done what was right,” she says. “And, you know, when people complain about things, I just look at them, like, ‘And what have you done about it?’ Not to be mean, but I've got to put it back in their hands.”

To reach senators’ and representatives’ offices, call the U.S. Capitol Switchboard at (202) 224-3121.

Now how did I get into this one?

I rolled onto my side for pressure relief. I have the laptop in bed next to me — I change the screen orientation to portrait so that it’s sideways, and this works pretty well. But as I’m working, I notice the craziest thing. There’s an arrowhead sticking out underneath my nipple, the bottom half of it anyway. Not a typical arrowhead, but a smooth plastic one, almost like a guitar pick. It even has a purplish composite pattern similar to a guitar pick. But it’s sticking out of my skin.

What the hell did I do now? It doesn’t really hurt and I didn’t even notice it going in, but Mab is going to blow her stack over this. I mean, how did I even do this? Because I’m always getting into bonkers crap by accident. Pulling the cantilever table off of the wall. Plunging into a ditch getting the mail. Rolling over a floor-mounted art installation. Ramming into my desk while trying to sidle up for a sip of water and finding out I sliced back a layer of skin on my forearm. My chair ought to come with safety cones because I’m a rolling disaster.

To make things worse, the arrowhead is a good ways in, and angled so that it’s disappearing under my skin … almost like my otherwise healthy skin is pulling back into position and bringing the arrowhead with it. No blood yet but I’ve got to work fast before things get sloppy. Mab has forceps that would be perfect for this but by the time she gets here it’s going to be lost under the skin and then it’s a trip to the ER and all of that. So, I didn’t have much extra fingernail but I try pinching the small corner of arrowhead before it disappears, before it turns into a UN incident.

It’s while I’m pinching at the thing — unsuccessfully, because it keeps sliding further under my nipple — that I realize that I haven’t been able to move my hand this much in years, so either this is such an emergency that my body is pumping miraculous amounts of adrenaline into my hand (something like this has happened before, but that’s another story),

Or I must be dreaming.

Postscript. It was very comfortable lying in a new position like that. When I awoke, my nipple was not pointy. I was not in trouble with Mab. I don’t take naps, but that was a helluva good one.