Legislative Issues

Advocacy Report

More Attacks on Healthcare: Graham-Cassidy Bill as Harmful as Previous Bills 


The US Senate is continuing efforts to cut healthcare, rehabilitation and support services for persons with disabilities, including survivors of brain injury. 

Your continued outreach to Senators Roy Blunt and Claire McCaskill are vital - TODAY. The Senate is fast-tracking the Cassidy-Graham Bill that has the same damaging provisions that will decimate Medicaid, leaving many persons with brain injury without needed services. They intend to vote on this bill next week, September 28. Your action is needed today.

Please email, call or visit the offices of Senators Roy Blunt and Claire McCaskill with the following message: 

Please OPPOSE the Graham-Cassidy Bill. The per capita cap and block grant funding for Medicaid will cut much needed healthcare, rehabilitation and support services for persons with disabilities, including individuals with brain injury. 

What the Graham-Cassidy Bill does to persons with brain injury: 

  • It decimates the Medicaid program by placing a per-capita cap and block grant funding for services until 2026. After 2026, there will be no funding for healthcare, rehabilitation and support services for individuals who need Medicaid for these services.
  • It puts the Essential Health Benefits at risk and allows states to remove covered services like rehabilitative care, opioid treatment and mental health treatment. 
  • It allows insurance companies to discriminate against people with pre-existing conditions, including disabilities from brain injury. These individuals will most likely end up paying higher insurance premiums and potentially be priced out of the health insurance market.

These changes are unacceptable and cannot be tolerated. Please contact Senators Roy Blunt and Claire McCaskill now. 

Read more about the Graham-Cassidy Bill now. 

Bottom Line -- We need to do an all-out assault on this bill to protect Medicaid and protect the supports that make it possible for those who are aging, people with disabilities, and children with complex medical needs to live at home, with their families, or in the community.

Contact Senator Roy Blunt   
Senator Roy Blunt Email Form

Cape Girardeau



Kansas City 
Fax: 816-471-7338


Phone: 417-877-7814
Fax: 417-823-9662

St. Louis 
Phone: 314-725-4484
Fax: 314-727-3548

Washington D.C. 
Phone: 202-224-5721

Contact Senator Claire McCaskill 
Senator Claire McCaskill Email Form

Cape Girardeau
Phone: 573-651-0964
Fax: 573-334-4278

Phone: 573-442-7130
Fax: 573-442-7140

Kansas City
Phone: 816-421-1639
Fax: 816-421-2562


Phone: 417-868-8745
Fax: 417-831-1349

Saint Louis

Phone: 314-367-1364
Fax: 314-361-8649

Washington D.C.

Phone: 202-224-6154
Fax: 202-228-6326

Services Are At Risk

Thousands of survivors of brain injury in Missouri need Medicaid for healthcare and community supports. These individuals often have long-term disabilities such as limited mobility, vision, hearing or balance impairments, mental health disorders and much more. The services needed are at risk of being eliminated or reduced due to budget cuts.

The current proposed Federal FY18 Budget includes block grants and per capita caps for Medicaid. Block grants and per capita cap funding are when the Federal government has a pre-determined amount for the State of Missouri to provide Medicaid services for individuals, including persons with brain injury.

Historically, the amount of money for block grants and per capita cap funding does not increase – EVER.  The amount received in year one is the same as in year 10, 20 and so on. The result is cuts in services for survivors of brain injury who need healthcare and community supports through Medicaid to live within the community. The alternative is individuals living in nursing homes at a higher cost to taxpayers.

The Brain Injury Waiver was a promising option for survivors of brain injury to receive rehabilitation and transitional support services within their home. This hope is now gone, or at least delayed, with the veto of House Committee Bill (HCB) 3 in June 2017.

The $500,000 that was included in HCB3 through a legislative process of using surplus revenue from various Funds would have enabled the Brain Injury Waiver to move forward. Without this FY18 funding the Brain Injury Waiver application developed by the Department of Health and Senior Services, with input from stakeholders, including BIA-MO, survivors of brain injury and family members, had to be put on “hold” until funding is available.

Good news is that the all-rider motorcycle helmet law in Missouri is still in effect. During the last week of session in May 2017, amendments to repeal our motorcycle helmet law were added to unrelated bills. Missouri Senators and Representatives showed leadership and commitment to save lives by removing these amendments during bipartisan, House-Senate Conference Committee meetings.

During most of the Missouri legislative sessions, there are threats to our all-rider motorcycle helmet law. Our motorcycle helmet law is one of the strongest in the country and it saves lives, prevents brain injuries and saves taxpayer dollars.

What are the next Advocacy steps?

  • Sign-up for Advocacy Alerts from the Brain Injury Association of Missouri by sending an email to The Brain Injury Association of America has a Policy Corner e-newsletter that you may subscribe to at     www.biausa/biaa-advocacy.htm.
  • Contact your US Senator or Congressperson at 1-202-224-3121, or their local offices, with the following message:

OPPOSE Block Grants and Per Capita Caps for Medicaid in the FY18 Budget. The result will be cuts in services for persons with brain injury and resulting disabilities.

  • Contact your Missouri State Senator and Representative at 1-573-751-2000 or their local office to share the following message:

SUPPORT funding of $500,000 or more for a Brain Injury Waiver. These services are desperately needed for survivors of brain injury to receive rehabilitation and transitional support services so they have better opportunities to return to work and live within the community.

OPPOSE any legislation that repeals or weakens the Missouri all-rider motorcycle helmet law. Your NO vote will save lives, prevent brain injuries and save our tax dollars.


Our voices need to be heard by elected officials at local, state and federal levels. Your sharing of personal and professional stories will educate your representatives about brain injury and issues important to survivors, families and the community.

It only takes 10 emails, phone calls or letters for an elected official to take notice of an issue and the requested position of constituents. Please be one of the 10 people to contact your elected official today.

Please let me know any questions at or 314-426-4024.

Brain Injury Association of Missouri, Inc.

2265 Schuetz Road

Saint Louis, Missouri 63146

Toll Free 800-444-6443

Phone 314-426-4024

Fax 314-426-3290