With Republican lawmakers considering significant cuts to Medicaid, the healthcare coverage and critical support services that millions of Americans rely on could be in jeopardy. Among the many people who could be affected is Bryce Rafferty, age 35, a Denver lawyer who says he can’t imagine what his life would look like today if it weren’t for Medicaid and related support programs. 

An accident that changed his life

In 2009, when he was 20 years old, Rafferty suffered a life-changing injury. Just five days into a study abroad program in Switzerland, he dove off a pier and suffered a cervical spinal cord injury. He remained in Switzerland for several months during an extensive recovery, which included 45 days in the ICU and more than a month on a ventilator. He then returned to the United States for specialized surgery in Denver – which was convenient because at the time he attended Colorado College in Colorado Springs, so he had friends in the area. 

After a brief stay at home in Connecticut, he returned to Colorado Springs, where he received home health care on a daily basis through Medicaid. 

He says Medicaid played a pivotal role in helping him recover, while also allowing him to pursue his professional goals and live independently. 

“Home and community-based services (HCBS) enabled me to return as a quadriplegic to Colorado College to finish my degree.” After graduating, Rafferty moved to Denver, where he says the HCBS support “enabled me to live independently in the community, in the state where I wanted to live, ever since my first 48 hours in Colorado.” 

Multi-faceted support for all parts of life

While home health care was important, Rafferty says the services he received through Medicaid and related programs went way beyond that. “There are other services tied to Medicaid and public benefits—on a state and federal level—up to and including occupational therapy, physical therapy, and specifically the Division of Vocational Rehabilitation, DVR.” 

It was through the DVR that Rafferty was able to access help in getting modifications done to his van, which provided further independence in the form of transportation he could use on his own—which in turn allowed him to work. 

Finding a new calling

Rafferty soon discovered he had a passion for advocacy. He started out doing disability advocacy of various kinds on a volunteer basis and testifying in front of lawmakers and agency leaders in support of disability-related legislation. Throughout this period, he continued to rely on a variety of support services provided by Medicaid. 

“What Medicaid did for me was enable me to go back to school, graduate from Colorado College, really find some purpose and meaning after graduating by working, doing volunteer advocacy, and being able to drive from my power wheelchair.” 

Rafferty decided to pursue a law degree at Sturm College of Law at the University of Denver – and he graduated without any debt. This was an incredible feat he says was possible only due to the support he received from the DVR, which helped with his tuition bills and also paid for books and other supplies. The support from safety net programs—specifically Medicaid and the DVR—also helped him meet his basic needs on a daily basis.  

He cites Consumer-Directed Attendant Support Services (CDASS), which lets Medicaid recipients direct and manage the attendants who provide their personal care, homemaker, and health maintenance services, as playing a pivotal role in his ability to survive and thrive. 

“Without that, I would not have been able to get up in those early mornings and have the kind of homemaker services that kept food in my fridge and getting help to get to law school with the supplies and things that I needed. I was put into a position to succeed in spite of my significant physical limitations because of Medicaid and Medicaid-funded services.”

While in law school, Rafferty completed several internships, including one with the Colorado Cross-Disability Coalition. That experience gave him insight into the organization’s important work to ensure state and local laws meet the needs of Colorado residents with disabilities. After graduating from law school, he ended up returning to the CCDC, where he now serves as a staff attorney on a contract basis. 

Support that helps those with disabilities become productive and independent

Rafferty notes that as a result of CDASS, he has essentially “become a small business owner employing seven caregivers. I’m paying rent, hopefully a mortgage soon, paying taxes. I’m working, I’m patronizing businesses. I’m an active part of society, and to the extent that Medicaid has really invested in me, now I’m turning towards giving back, in the sense of continuing the progress that’s been made in disability rights and integrating people with disabilities in the community settings—promoting not just physical independence, but financial independence, education, and all of the aspects of life that everybody wants.” 

Rafferty says he tries not to imagine how different his life would be if he didn’t have access to Medicaid and similar safety net resources. “If we zoom out to a 30,000-foot view, Medicaid was at the core of what enabled me to take a situation that at age 20 could have totally ended my life vocationally and in terms of physical independence and financial independence—and instead, I am now living independently in the community. I am working for a nonprofit, advancing disability rights in a very tough time where I believe my voice can make an impact.” 

None of the core elements of his current life would have been possible without safety net programs, Rafferty says. “I’ve been able to benefit from society’s decision to support this kind of trajectory for people with nursing facility level of care needs. And in America, the only way that I can do this is through Medicaid.” 

While the talk of Medicaid cuts makes him nervous, Rafferty says he also feels disappointed that some lawmakers don’t seem to consider support for people with significant disabilities to be an important priority. 

“With Medicaid on the chopping block, people like me are apparently expendable,” he says. “But you can’t put five or six million people with acute needs into institutions that don’t exist, right? There’s no capacity, and the cost would be enormous. People like me would end up in emergency rooms. We’d end up homeless, potentially incarcerated, or end up having to move back in with family. Then they would have to become caregivers, and they would have to potentially give up on their work. And it would just be just dominoes of what could be really just economic and societal collapse.”