Cedar Rapids and the birth of the Medicaid waiver

GUEST COLUMN | JENNY BOSKING

As debate continues in Washington over potential cuts to Medicaid, it can be difficult to fully understand the many components of the program and their impact. While it is prudent to evaluate spending and outcomes when making budget decisions, one story from right here in Cedar Rapids deserves particular attention — not just because of its local roots, but because it embodies both visionary fiscal responsibility and extraordinary compassion.

Medicaid waivers, a critical support system that allows families to care for disabled loved ones at home instead of in institutions, represent one of the most meaningful innovations in disability care. More than just a compassionate solution, the waiver model is also cost-effective and family- centered — and it began right here in Cedar Rapids.

In the late 1970s, Julie Beckett was a mother caring for her profoundly disabled daughter, Katie. At the time, parents were often forced to institutionalize their children once home care became too difficult or too expensive. These institutions, while intended to provide support, often lacked the individualized care and love that only a family could provide. For many families, the choice to institutionalize was heartbreaking — made worse by the knowledge that better alternatives existed.

Julie Beckett believed there was a better way. She advocated for a new approach that would allow families to receive modest financial support to continue caring for their loved ones at home. In her search for a champion, she connected with then-presidential candidate Ronald Reagan. He recognized the value of Julie’s idea: by offering families a fraction of what institutional care would cost, the government could save money while improving quality of life for those in need.

After his election, President Reagan supported the idea, and the Katie Beckett Medicaid Waiver program was born — making a Cedar Rapids innovation a national reality.

Julie Beckett’s courage and advocacy reshaped disability care in America. Her legacy reminds us that thoughtful, compassionate solutions can emerge from local voices and that meaningful change often begins with one determined individual.

Cedar Rapids is known for producing world-class athletes, artists, and inventors like Grant Wood, Zach Johnson, Howard Hall and Arthur Collins. But we should also remember the visionary advocates — like Julie Beckett — whose quiet revolutions have touched millions of lives. When we talk about the proud history of our city, the story of the Medicaid waiver should be told alongside our greatest accomplishments. Julie Beckett didn’t just help her daughter — she helped a nation.

Jenny Bosking is development & communications director with The Arc of East Central Iowa.