For John and Claudia Dery, Medicaid is one of the ways they’re able to navigate life dealing with John’s multiple sclerosis – including helping to pay for three days a week of care at Mondanock Adult Care Center in Jaffrey.

On Wednesday, Democratic U.S. Rep. Maggie Goodlander visited the center to hear from the Derys and those that run the center about the role Medicaid assistance plays in keeping their doors open. The center is a day program that picks up clients in the morning and drops them off at home in the afternoon. It serves families who can care for their family members during nights and weekends, but need support during the working hours.

The Monadnock Adult Care Center, which is under the umbrella of Monadnock Family Services, was one of several stops Goodlander made last week, speaking to various populations that access and rely on Medicaid for health care. Medicaid relies on funding from both the state and federal governments, and are administered within each individual state. The recently passed U.S. House of Representatives budget resolution includes a 10-year plan which would reduce federal Medicaid spending by $880 billion, though details of where those cuts would come from are yet to be finalized.

“What we’re up against is the biggest cuts to Medicaid in American history. The budget resolution that House Republicans introduced, on a partisan basis, last month, that I voted no on, would cut $880 billion in health care, so we’re talking Medicare, Medicaid, and these are programs that matter to this community, and matter to communities across New Hampshire,” said Goodlander in an interview.

She said for populations like those that rely on Monadnock Adult Care Center, these are “life-and-death” decisions.

“I’m focused on getting the facts and getting the best case possible, because no one voted for the largest cuts to Medicaid in American history; no one ran on that,” Goodlander said. “The real harm it’s going to cause real people, right here, is unacceptable. This is not what anyone voted for; this is not what our country’s about.”

Goodlander said she first heard about the Monadnock Adult Care Center when the Derys attended one of her town halls in Keene, and spoke about their experiences there.

Claudia Dery said she and her husband have been dealing with the effects of John’s multiple sclerosis for 30 years. It was about five years ago that he started attending the Monadnock Adult Care Center, after it became apparent that it was no longer viable that he be left home alone. At that time, Claudia said she was still working as a teacher, though she’s now retired.

She said that paying for private care seemed insurmountable, between her paycheck and John’s disability benefits.

“I was a teacher – we were making just enough to scrape by,” Claudia said. “Then someone suggested we apply for Medicaid.”

That was its own battle, Claudia said, requiring an advocate to help navigate them through the process, but eventually they were able to apply and receive Medicaid benefits, and start John at the Monadnock Adult Care Center.

Melinda “Mindy” Asbury, the chief medical officer and interim chief executive officer of Monadnock Family Services, said that MFS has 27 programs, some designed for specific populations, ranging in age from children to the elderly. She said last year, the agency faced a $1.3 million deficit – the Monadnock Adult Care Center representing about $370,000 of that –  in large part due to insurance companies not reimbursing for care.

“We’re running into a significant amount of uncompensated care,” Asbury said.

Chris Selmer of the center said that’s a reality facing many care centers dealing with vulnerable populations. She said when she started in the adult care business 25 years ago, there were 26 facilities across the state; now, it’s 11, and Monadnock Adult Care is the only one in the area, serving clients from 16 towns.

“They’ve gone away because they cannot sustain the cost,” Selmer said. She said that’s devastating for families, because it leaves them few other options to care for family members during the day, and often the only other answer is a nursing home.

“Our focus is to keep people living in the community they want to be in,” Selmer said. “And supporting the family as much as the clients. Our program is so important because if we weren’t here, their options become less, and people would be entering nursing homes far before they needed to.”

Ashley Saari can be reached at 603-924-7172, Ext. 244 or asaari@ledgertranscript.com. She’s on X @AshleySaariMLT.