Children hit hard by GOP health bill – The Herald Bulletin




WASHINGTON — Dr. Lisa Costello, a pediatrician in Morgantown, West Virginia, says about a third of the children she sees are on Medicaid.

So with Senate Republicans considering reducing funding for the program in their health care reform bill, she’s worried.

“Medicaid is a lifeline,” she said this week. If the cuts lead to some being pushed off the program, as health care analysts warn, she worries fewer parents will bring their children in for regular checkups, and “time is of the essence,” she says, in being able to identify problems that could lead to lifelong problems.

A specialist in treating patients with cystic fibrosis, she worries some of her patients may not be able to afford their medication that helps keep them from having trouble breathing or digesting food.

Proposed changes to Medicaid funding in the bill continue to be an obstacle as Senate leaders try to rally the 50 votes needed to even bring the measure up for a vote, much less pass it next week.

Holding only a two-vote majority, Senate leaders can only afford two defections. However, a number of moderate Republican senators like West Virginia’s Shelley Moore Capito and Maine’s Susan Collins are troubled its impact on Medicaid funding.

With conservatives hoping to rein in rapidly-growing federal spending on the low-income health care program, the bill would reduce funding to 31 states and the District of Columbia that expanded Medicaid to people making just over the poverty line.

It would also cap and reduce the increase of spending for the traditional program.

Much of the debate has been on the impact the bill would have on patients’ ability to get drug treatment. But the bill is also facing opposition from children’s advocates like pediatricians because nearly half of those getting health coverage from children are on Medicaid.

Nationally, 34 million of the 80 million on Medicaid are children. But they make up a majority of Medicaid recipients in a number of states like Georgia, Indiana and Oklahoma, according to the Kaiser Family Foundation.

A study by the Urban Institute estimated that the Senate bill would mean more than 4 million children would lose their health coverage, mostly because of the Medicaid changes. That would leave about 9.5 percent of children uninsured after the rate dropped to 5 percent under the Affordable Care Act.

The change would be dramatic in some states. The nonprofit think tank estimated the number of uninsured children would quadruple in some states like West Virginia and Kentucky, and more than double in others like Iowa, Michigan, Minnesota, Missouri, Ohio and Pennsylvania.

In a statement opposing the bill, American Academy of Pediatrics President Fernando Stein tried to put a human face on the issue.

“Medicaid covers a grandmother’s chemotherapy and a newborn baby’s emergency heart surgery and a 6-year-old’s hearing screening and a teenager’s asthma inhaler,” he wrote.

In addition, the bill is being opposed by local school administrators who fear it would mean the loss of some of the $4 billion annually schools get for nurses, social workers, psychologists, speech pathologists and medical equipment.

The Senate bill does contain an exception to allow more spending for disabled children, but Sasha Pudelski, assistant director for policy and advocacy for the school administrators association, said the definition of disabled is drawn too narrowly and schools would still take a significant hit.

However, undecided senators like Capito and Indiana Republican Sen. Todd Young are under intense pressure to support the measure and repeal the Affordable Care Act as Republicans have promised for years.

Responding to concerns from conservatives that the law requires people to buy expensive comprehensive plans, it would allow insurers to offer more affordable catastrophic coverage that covers fewer conditions and has high deductibles.

The bill’s proponents also deny proposing drastic cuts to Medicaid, because funding for the program spending will continue to grow. But critics say that’s because it would now grow less than health costs are rising.

Earlier this week, the Indiana Association of Public Schools, the Indiana Rural Schools Association and several school districts wrote Senate leaders saying 140 school districts in the state received $12 million in Medicaid funding last year.

They warned reducing the funding would mean “districts will have to lay off school personnel like nurses, counselors and therapists.” They also said “basic medical screenings covered by Medicaid to identify vision, hearing, and mental health problems of students would no longer be possible.”

Steve Thalheimer, superintendent of the Fairfield Community Schools in Kokomo, Indiana, said the $3,000 his district received last year was among the least in the state.

Still he warned the loss of funding could mean the district could no longer provide trainings to teachers and school staff on how to deal with disruptive students without having to restrain them.

Thalheimer, who was among those writing senators, said cuts would put students and staff in more danger.

In Jackson County, West Virginia, a community reeling from the closure of an aluminum plant a few years ago, schools Superintendent Blaine Hess said Medicaid funds help pay for school nurses as well as other staff to work with special needs children. The district couldn’t make up for the loss, he said, because “a lot of schools are just trying to stay solvent.”

Because federal law requires the schools to provide services for special needs students, losing Medicaid money would mean having to cut services for other children, he said. That would make it harder for the area to attract new companies looking for well-educated workers.

At the rural community of Danville, Pennsylvania, Dr. Pat Bruno also worried about the impacts if more low-income children lost their health coverage.

Fewer parents might bring their children in for regular checkups or immunizations, he said, “if they have to choose between food, groceries and a doctor’s bill,” said Dr. Bruno, a pediatrician at Geisinger Medical Center.

When he began his medical career in the 1970s, “we were treating all sorts of infections from things like meningitis. Fortunately children are getting immunizations now,” he said.

Contact Washington reporter Kery Murakami at kmurakami@cnhi.com.

Effects of BCRA on Indiana uninsured children, 2022

• ACA – 104,000

• Share of state child population – 6.1%

• BCRA – 177,000

• Share of state child population – 10.3%

• Percent change from ACA – 69.4%

Source: Urban Institute analysis



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