“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.
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