Children big losers in House health care rewrite

Children big losers in House health care rewrite

(District of Columbia) Legislation to repeal and replace Obamacare could have resulted in the elimination of benefits to millions of low-income children, shifting some of those services to schools, according to analysis from a national advocacy group.

Although the health care bill failed to win enough support in the House of Representatives last month, new focus has been directed to the rewrite of the Affordable Health Care Act as discussions continue between Republican Congressional leaders and the White House on a revised package.

While President Donald Trump blamed the far right wing of the GOP for the bill’s downfall, there were also many moderate Republicans who were uneasy about how low-income families would be treated under the replacement scenario.

But a detailed review from the First Focus Campaign for Children suggests how children would fare specifically is another area of concern given that the replacement legislation would reduce Medicaid spending by about $880 billion.

“States are likely to respond to the hundreds of billions of dollars in federal cuts in a manner that would likely weaken the coverage, benefits, and affordability that Medicaid provides many of our nation’s most vulnerable and fragile children,” said Bruce Lesley, president of First Focus in a letter to House leadership late last month.

“We are talking about children in poverty, children who have been sexually or physically abused and neglected in foster care, newborns, kids in need of an organ transplant, and children with cancer, cystic fibrosis, asthma, mental and behavioral health needs, oral health care, spina bifida, Rett’s Syndrome, Fragile X Syndrome, traumatic brain injury, heart problems, bleeding disorders, genetic birth defects, etc.,” he said.

The legislation would have created 255 separate ‘per capita caps’ on state Medicaid spending, Lesley said, that would overtime restrict what would be available to support the cost of caring for the elderly, blind and disabled, as well as children.

“This is a fundamental and radical change to the financing of Medicaid — with the goal of slashing hundreds of billions of dollars out of the program,” he argued. “The change represents a fundamental abdication of the federal government’s shared responsibility with states that it has shared throughout the 52-year history of the Medicaid program to provide health coverage to our nation’s low-income children, people with disabilities, and senior citizens.”

He said that the bill would have applied an inflation rate that would burden child care more heavily, and thus, cause children to “disproportionately bear the brunt of the cuts that states would need to impose” in order to meet cap limits.

The caps would also have degraded reimbursements to providers, which would tend to “undermine the health care system and the providers serving children, including hospitals, doctors, nurses, clinics, school nurses, and other health professionals.”

As state support for services ebbs and services for children are cut out of Medicaid, “those costs will increasingly be picked up by other areas, such as our nation’s schools, foster care, and juvenile justice systems,” Lesley said.  “This is not an appropriate cost-shift and would negatively impact those systems and services for children. And we must recognize that some services will be lost completely and not picked up by the states at all.”

Although the version of the health care bill that Lesley reviewed never made it to the House floor because of a lack of support, the White House continues to lobby for that bill—or another version—to be taken up and early as sometime this week.