By Fernando Stein, MD
The bill fails children by dismantling the Medicaid program, capping its funding, ending its expansion and allowing its benefits to be scaled back. The bill fails all children by leaving more families uninsured, or without insurance they can afford or that meets their basic needs. This bill fails children living in or near poverty, children in foster care and children with complex health care needs whose parents have private insurance – all of these children depend on Medicaid, and if this bill passes, Medicaid will no longer be there for them.
The bill includes misleading ‘protections’ for children by proposing to exempt them from certain Medicaid cuts. A ‘carve-out’ for children with ‘medically complex’ health issues does little to protect their coverage when the base program providing the coverage is stripped of its funding. Doing so forces states to chip away coverage in other ways, by not covering children living in poverty who do not have complex health conditions, or by scaling back the benefits that children and their families depend on. This bill would make a child’s access to health care dependent on his or her ZIP code and force states to make decisions about which vulnerable population gets services. Put simply, this bill is bad policy for children.
Pediatricians understand that Medicaid is not just an entitlement program; it’s an empowerment program. Medicaid allows a college student with cerebral palsy to live independently. Medicaid pays for a toddler’s wheelchair, and as she grows over time, it covers the next one and the one after that. Medicaid is there for families struggling from the opioid epidemic, covering treatment for parents and services for their children. Medicaid covers a grandmother’s chemotherapy and a newborn baby’s emergency heart surgery and a six-year-old’s hearing screening and a teenager’s asthma inhaler.
The bill that the Senate unveiled today was crafted without the benefit of groups like pediatricians weighing in with what children need. The result is that the bill would tear down the progress we’ve made by achieving health insurance coverage for 95% of America’s children. We cannot let that happen, which is why the American Academy of Pediatrics is leading its 66,000 members in a day of action today to protect Medicaid.
There is too much at stake for those of us who care for children to be silent. Pediatricians will continue to speak out for what children need until we see legislation that reflects it.