The Trump budget proposal is all out war against the disabled, the elderly, the poor, those who are Black/POC, and LGBTQIA, particularly trans, people. God forbid we’re multiply marginalized, and a part of all these identities. With cuts proposed to Medicaid, food stamps, and disability benefits, thousands if not millions of us are likely to die. This is not just a hardship. We are looking at an inevitable genocide, and they are coming for the disabled and older Americans first.

They always come for those of us who are disabled, first. It was what Hitler did, with his Aktion T4 program, so it is not surprising that Donald Trump and his administration would target us first. Regimes like this target disabled people because there already is a narrative surrounding the idea it is better to be dead than disabled. We are seen as a burden on society, and our lives are seen as meaningless or not worthwhile. This is the kind of thought that provokes the idea that we are dragging down society, and making life worse for the nondisabled majority. Such rhetoric is how regimes like this get support for cutting essential services, lifesaving services, that often make disabled people more productive and independent citizens. It’s how they get support for getting rid of us.

For me, healthcare is the difference between life and death. Right now, that healthcare is only available through Medicaid. It is the only program that offers waiver services that provide home healthcare and other essential services to wheelchair users like myself. I am 36 years old, and have a degenerative neuromuscular disability, Spinal Muscular Atrophy. To liven things up, I also have chronic pain, asthma, neuropathy, and OCD. I have used a wheelchair since I was 16!

It’s my 20-year chair anniversary this year – a day I celebrate as me getting back the freedom to move. I’m also employed as a writer/filmmaker, with a part-time gig working for the Center for Disability Rights. I am a tax paying citizen with potential for so much more, but I am limited in the work I can take, just so I can get out of bed, eat, and go to the bathroom thanks to Medicaid home healthcare waivers. At least I have them. The system is not perfect, it must be fixed, but taking away critical care services is not the right way. Many of us will not survive without them.

Medicaid services ensure that people like me, who can’t physically do everything for themselves, can lead independent lives. Medicaid waivers pay for equipment I could not otherwise afford, things like modifications to my wheelchair and shower chairs. They sometimes help with home renovations, like adding a ramp on a house or making a bathroom accessible. Medicaid pays for medications disabled people may not be able to get help paying for anywhere else, therapies not otherwise available, prepared meals if you cannot cook, and home healthcare, which allows someone like me to get out of bed, go to the bathroom, eat, get dressed, and go to work. These are not wants, they are needs. They are things we must have to survive, and even when I was working three jobs, I could not afford them out of pocket.

It’s important to know this background, to better understand the context behind my fear of the AHCA or the Trump budget passing. One aspect that has been only lightly touched upon by most of the major media coverage of the AHCA legislation is the large amount of money that will be taken from Medicaid. Medicaid is already struggling, and disabled people, like me, are the ones who bear the brunt of any cuts. Nearly $1 trillion will be cut from Medicaid if this bill passes in the Senate. Not only will disabled folks lose their healthcare and essential waiver services, these cuts ensure many will end up dead. If not dead, we will be left to rot in institutions on the taxpayers’ dime, a cost more expensive than the cost of services that support living in our communities through Medicaid waivers.

The very same thing will happen if Donald Trump gets Congress to pass his budget proposal considering he basically made the same cuts to Medicaid services. Regardless of whether the AHCA passes, Donald Trump is determined to make disabled people suffer. I would like to say that Congress will reject this budget proposal, but we don’t have a Congress that is doing the job they’re supposed to currently, so I don’t have much hope. For those of us with disabilities. We are once again left on our own to fend for ourselves.

Disabled lives have value and meaning. We can show our value better when we have the tools to be independent. We can better integrate into the world when we have access to the healthcare we need. It is even harder for those of us multiply marginalized by gender, sexual orientation, and/or race, on top of disability. Our access to essential health services may already be further hindered. To take these services away indefinitely is cruel and unusual punishment.

This world is our world, too. Please don’t take away the things we need to live in it. Like everyone else, disabled people deserve the chance to live our lives.