By Anastasia Somoza

I have cerebral palsy spastic quadriplegia. I require 12 to 16 hours of personal care assistance a day to help with my activities of daily living. I need help getting out of bed, using the bathroom, showering, dressing and being positioned in my wheelchair, all before I go to work at 9 a.m. — the very things able-bodied people take for granted. I am limited in how much I can work while still receiving this much-needed daily assistance under Medicaid. As a young woman with a lifelong pre-existing condition — and like many people with disabilities or low-income persons relying on the Affordable Care Act — I am terrified of what the upcoming elections will do to my tenuous hold on my health insurance.

Across the country, our health care under the ACA, Medicaid, and Medicare is suffering what I call “death by a thousand cuts” — changes gradually chipping away at what services we can or cannot receive. As I write this, the reality is that many young and otherwise healthy women and men with disabilities who are trapped in nursing homes or hospitals have no chance of getting out.

Many who now live independently in the community with support covered by Medicaid and Medicare are at great risk of being placed in these facilities if their services are cut. For now, I’m a little luckier than most because I also have a loving and supportive family who could fight to make sure my twin sister, Alba, and I can maintain our quality of life and live safely, happily and independently in our community, never fearing having to go into a hospital or nursing home. But I know that millions of other Americans are less fortunate.

That’s why I am so concerned about the Republican plan to cut hundreds of billions of dollars from Medicaid. The threatened cuts would gut Medicaid, which would be disastrous for millions of Americans with disabilities. The cuts could mean the end of our independence and our livelihoods, and could even be detrimental to our health.

If Republicans get their way, low-income earners could be forced to pay out of pocket for essential supplies that were previously covered by Medicaid. For instance, my twin sister receives all her food and nutrients through tube feeding. The supplies enabling my mom and others to feed her and keep her G-tube area healthy and clean, which Medicaid used to cover, have become increasingly harder to get. When Medicaid stops fully reimbursing these life-sustaining supplies, medical supply companies stop providing them.

Moreover, the Republican health care plan would make it far harder for people with disabilities to work and thrive. I am proud of and grateful for my educational attainment, volunteerism, internships, and employment history, as well my current job. But without Medicaid, instead of contributing to the economy, I will become completely dependent on government assistance. This is not inclusive or practical — or fiscally responsible. It is far better to have people like me working, paying taxes, participating in the community, frequenting local businesses and enjoying life like anyone else.

Health care is a fundamental human right and must not be a partisan issue. We would hope that our elected officials would vote in the best interests of their constituents and their fellow citizens. But Republicans have decided their goal is to destroy the ACA and enact massive cuts to Medicaid and Medicare, even though millions of people with disabilities rely on this life-saving health care nationwide, including many of the people whose interests they are supposed to be representing.

Anyone whose ability to work, live, and participate in their community is in danger if they lose their insurance should go out and vote for the candidates who support our health care needs. That means voting for Democrats up and down the ballot. Beware of politicians who say one thing, and then do the opposite. Join me in supporting candidates who will protect Americans’ access to health care. My and my family’s futures depend on it.