Children Have the Most to Lose in Proposed Medicaid Cuts

Editor’s Note: This guest blog by David Rubin, MD, MSCE, director of Children’s Hospital of Philadelphia’s PolicyLab, discusses how deep Medicaid cuts could harm children and teens. (This text originally appeared in a PolicyLab newsletter. If you’re interested in receiving their newsletter, please visit their website to sign up.) In a previous post, Dr. Rubin reported on PolicyLab research that showed many low- and moderate-income working families rely entirely on Medicaid and the Children’s Health Insurance Program to provide cost-effective and comprehensive coverage for their children. The maintenance and protection of these programs is now more important than ever, yet the Senate and House are considering legislation that would leave many families vulnerable to gaps in coverage and benefits.

The Senate-proposed Better Care Reconciliation Act and the House-passed American Health Care Act (AHCA) risk undoing a half century of healthcare standards that were designed to maximize child development and well-being by cutting Medicaid funding and fundamentally changing the program. Yet, the intense discussion on the future of our healthcare system has really only been focused on adults. You would be hard-pressed to hear debate on how these changes would impact children, despite the fact that more than 36 million children and adolescents across the U.S. are insured through Medicaid.

Our resolve as PolicyLab researchers is to ensure that the public and our policymakers have a clear understanding of the strong data illustrating the harm to children and adolescents that might be introduced by this legislation. It is in this spirit that I wanted to share with you a Health Affairs blog post published this week. In it, I highlight how if the AHCA became reality, it’s impact would negate the gains made in reducing the uninsured rate in children and leave families with fewer options for their children’s healthcare. The bottom line: Although children remain outside of the public healthcare debate, they have the most to lose.

Across PolicyLab, our researchers have been vocal about how cuts to Medicaid may impact the specific patient populations that they see:

• Children with asthma: Asthma is the most common chronic condition among children, affecting nearly one in 10 children nationwide. PolicyLab researcher Chén Kenyon, MD, MPH, and Tyra Bryant-Stephens, MD, medical director of CHOP’s Community Asthma Prevention Program, write how cuts to the Medicaid program could hamper innovative population health solutions for children at the highest risk.
• Children seeking mental health services: Medicaid is the largest payer of mental health services for both adults and children, yet Stephanie Doupnik, MD, MSHP; Andrea Knight, MD, MSCE; Jennifer Gable, MPA, MBE; and Diana Worsley, MPH, note that even with its current funding, access remains insufficient for children living in low-income families, in foster care or with disabilities.
• Young people with complex medical needs: Medicaid covers 10.2 million adults and children with serious illnesses or disabilities whose health needs create significant financial burden for patients and their families. PolicyLab’s Sophie Jan, MD, MSHP; and Havi Glaser, JD, and Rebecca Kim detail what’s at stake for these young individuals’ care and schooling.

If Congress proceeds forward with any legislation that includes devastating Medicaid cuts, we will see states forced to make many difficult decisions that will affect both the families we serve and those across the country. Please join us in bringing to the forefront of the mainstream conversation the threats these proposals pose, not only to children’s coverage, but also to the care provided to them and their families.

The Health Affairs blog gives a helpful overview of the current issues and threats to children’s access to healthcare. Here is the full citation: David Rubin; Sounding the Alarms on Children’s Health Coverage; Health Affairs blog posted June 26, 2017; Copyright ©2017 Health Affairs by Project HOPE — The People-to-People Health Foundation Inc.