Medicaid loses out and the disabled take the hit.

• Author: Wright, Kai
• Position: Missouri

Wayne Fry is a hardworking guy by any measure. He spent his life toiling as a union carpenter in St. Louis, and in 1985 he used those skills to build a spacious house just west of the city. He wanted a big yard for his three daughters, and the schools out there were better. The money he saved on labor kept the cost down, and today his is still the only two-story house in a modest neighborhood, where the Stars and Stripes fly from mailboxes and hound dogs lounge unleashed in front yards.

In 1995, Fry's father died and left him some inheritance. Fry went straight to the bank and paid off the house. That prudence turned out to be more crucial than he could have imagined. Just days later, he finished building an add-on room and went outside to take a dip in his new pool. It was dark, and he didn't know the water had been drained.

"I jumped in, hit my head, snapped it back," Fry recounts in a matter-of-fact tone. "And that was it, broke my neck."

Now Fry is quadriplegic, limited to about the same mobility Christopher Reeve had. Still, he's been living independently since the injury.

"Physically, I know how bad I'm hurt. Mentally, just because I can't talk as good, don't assume that means anything," Fry explains in his slurred speech. "I'm not going in a nursing home. I'll stay in my house. I built the son of a gun; I'll die in here with dignity."

But dignity doesn't come cheap in today's health care economy. Fry is divorced, and his children are adults with lives and troubles of their own. He needs twelve hours a day of help from home health aides--not to mention the twenty-five meds he takes daily, the advanced-technology wheelchair he uses, and the host of other support devices he counts on.

For ten years, Missouri's public health insurance paid the bill. A special state program even let Fry work part time without losing his benefits. So he clocked in at a local nonprofit, helping other people with disabilities. And he took classes in computer-assisted design, hoping to get a gig modeling accessible homes.

"I was pretty doggone good," he says.

But all of that's gone now.

In 2004, Missouri elected Republican Governor Matt Blunt--neophyte son of House Majority Whip Roy Blunt. The state is now a leader in the Bush Administration's movement to gut public health insurance.

Blunt stepped into a fiscal crisis sparked by massive 1990s tax cuts. His solution: Cut hundreds of millions of dollars from Medicaid, leaving 90,000 people without coverage...