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Changes to Medicaid: The Health of 30 Million Children at Risk

March 13, 2017
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If we care about children in our city, in our state and in our country, we must care about what happens to Medicaid.

Medicaid is critical to the health of our children. That is why those of us in pediatrics are so concerned about the recently proposed American Health Care Act.

The proposal, in effect, puts the health care benefits of 30 million children who depend on Medicaid at risk. There is no guarantee that funds intended for child health care will be used for that purpose. There is no guarantee that children who most need coverage will receive coverage. The proposal must be altered and improved so the access children now have to health care is assured.

How is it possible that the American Health Care Act, meant to replace the adult-focused Affordable Care Act (or “Obamacare”), could have this detrimental effect on children? Because the newly proposed act changes the way Medicaid is funded, and children make up more than 40 percent of the Medicaid population.

The program provides health care coverage for children whose families may not be able to afford health care coverage otherwise. It allows them access to pediatricians and hospitals when they are sick; perhaps just as importantly, Medicaid gives children opportunities for preventative care that can keep them from getting sick in the first place.

Medicaid funding now rises (and falls) as health care expenses change, or as some conditions become more or less prevalent. The new proposal would lock in a “per capita cap” model starting in 2020. This limiting of funding to states may ultimately limit children’s access to care. It may also mean that when adult spending on Medicaid runs over its allotment, money intended for children will be used to cover the gap.

Many news stories have focused on the politics surrounding the replacement of the Affordable Care Act. When we read the new proposal, though, we concentrate on how it will impact children. This is not politics for us. This is fear that the youngest, most vulnerable population in the United States will be denied health care they need.

Approximately 53 percent of patients at Nationwide Children’s Hospital have Medicaid coverage. Approximately 1.2 million children in Ohio are covered by the program. It is the single largest insurer of children in the United States. If we care about children in our city, in our state and in our country, we must care about what happens to Medicaid.

Congress needs to protect access to child health care through Medicaid. It has not done the job with the American Health Care Act.