LET’S be honest: Taking health care away from our most vulnerable populations, including children from low-income families and children with special health-care needs, will not promote health and has nothing to do with care.
Washington state can proudly claim one of the country’s lowest rates of uninsured children, thanks to a longstanding commitment to providing access to timely, quality health care for kids. Medicaid covers more than 30 million children nationwide; nearly half of Washington’s children (more than 800,000) have coverage through our state’s Medicaid program, Apple Health for Kids.
Medicaid is the single largest insurer of children in Washington. Children enrolled in Medicaid do better in school, miss fewer days due to illness and are more likely to graduate from high school and attend college than their peers without health-care insurance.
A strong Medicaid program means children living in or near poverty get preventive care and immunizations to keep them healthy and ready to learn. It means children don’t have to go to the emergency room when they have a routine illness that could be treated more appropriately — and at a lower cost — in a primary-care setting. It means that children with disabilities get access to specialists and the therapy they need. It means children with life-threatening conditions can receive treatment without devastating financial consequences to their families. It means children in foster care who face poverty, family dysfunction, neglect and abuse have access to the consistent health care they need to thrive.
Who would be so cruel as to deny children this care?
Apparently many in Congress would. The “American Health Care Act” (AHCA), the House version of health-care reform, is estimated to result in a 21 percent cut ($708 million) to Medicaid funding in our state starting in 2020. Our state estimates that the number of uninsured children would increase by 136 percent — a return to the levels of uninsured children before Medicaid expansion. According to the nonpartisan Congressional Budget Office, the Senate version of health-care reform, the “Better Care Reconciliation Act,” would leave an estimated 22 million people uninsured by 2026.
With fewer federal dollars our state will be forced to make significant cuts. Whether Congress calls for per capita caps or block grants, the real world effect will be devastating to states. Per capita caps on funding would result in a $43 billion reduction in federal funding for nondisabled children from 2020-2026. As a result, states could be forced to limit duration and scope of benefits for children, increase cost sharing for families, and institute more stringent prior-authorization requirements. The ability to fund across enrollee groups puts children at added risk vs. the elderly and people who are disabled. That’s a cruel choice to task states with making.
Increasing the number of uninsured children is no way to reform health care. The cruel irony in putting Medicaid at risk is that providing health care for children is not just a moral obligation, it’s also fiscally responsible. Children are not the cost drivers of Medicaid — they represent 46 percent of all Medicaid enrollees in Washington, but they account for only 18 percent of our state’s Medicaid spending. Investments in child health pay off for years to come, by preventing many chronic illnesses and detecting and addressing other health problems early, before they become serious and costly.
Let’s stop calling these efforts health-care reform. They do nothing to promote health and are devoid of care. Let’s call them what they are: Policies designed to provide tax breaks on the backs of those who can least afford to lose access to health care.
Real health-care reform would focus on providing the most cost-effective care and reducing waste in the system instead of wholesale tearing down the safeguards Medicaid provides for child health. Sacrificing our children is too high a price to pay.