Today’s American Health Care Act Places Children at Grave Risk

Today’s American Health Care Act Places Children at Grave Risk

Our President and CEO Pat Magoon and Dr. Matt Davis, Head of Academic General Pediatrics and Primary Care at Lurie Children’s, share their thoughts on the proposed American Health Care Act (AHCA) in this opinion piece published in Crain’s Chicago Business.

The race to bring major change to the nation’s health care system is putting America’s children at grave risk.

The American Health Care Act (AHCA) proposes major changes to the federal Medicaid program, which is the single largest source of health coverage for children in America today. Over 30 million children in the United States—from the youngest premature infants, to young children with autism or heart disease, to teenagers with asthma or muscular dystrophy—are currently insured by Medicaid. Most of these children are from low-income families, because of eligibility established across all states during the Reagan era. Some children on Medicaid are also from middle-class families, whose private health insurance has not been adequate to cover their children’s medical bills.

Under the AHCA plan, all people who depend on Medicaid for help in paying for health care would lose over $800 million in federal support. As a result, the burden would be shifted to the states. According to the American Hospital Association, Illinois will lose $21.2 billion in federal spending over the next ten years.  Most states, like Illinois, cannot afford increased budget obligations.

There is no escaping the conclusion that such major changes in Medicaid will affect children very broadly. More than 40 percent of Medicaid enrollees nationwide are children. In Illinois, almost 50 percent of Medicaid enrollees are kids. If this health plan is truly to be the American Health Care Act, it must be changed to safeguard access to care and funding for children insured by Medicaid, rather than putting children at risk.

This is no academic, “Beltway” policy issue to the doctors and nurses of our nation’s hospitals that specialize in taking care of children. They save babies’ lives when they are born too early. They cure cancer for children whose illnesses were not survivable just two decades ago. They provide transplants for children’s whose organs are not working as they should. They also focus on helping children be as healthy as they can be. These innocent children are covered by the very same Medicaid that would be decimated by this proposal. For these health care professionals, Medicaid is the key federal program that helps make children’s health care possible every day.

It’s important to know that, despite the large number of children on Medicaid, they only account for 20 percent of program costs. Studies demonstrate covering children through Medicaid yields great return on that investment as those children grow up. As adults, they are healthier and use emergency rooms and hospitals less frequently than adults who lived in poor households as children without medical coverage.

That means doing the right thing for children can also be the right decision for the federal budget. If Medicaid is to be cut, the cuts should be “surgical”—to spare our children.

To save our children, we urge Congress to sustain funding dedicated to children’s care and prohibit states from moving children’s funds to other purposes. In addition, any health reform must preserve federally mandated benefits for early prevention, diagnostics, screening, and treatment for children.

If Congress insists on major Medicaid reform that puts caps on federal spending, there must be realistic growth rates in funding. Under current plans, states will receive less real purchasing power from the federal government and will have to make up the difference by limiting benefits or restricting pediatric medical care.

If Medicaid reform cuts federal spending and provides per-person caps or block grants to states instead, we urge Congress to include all children—well and disabled—in one category and ensure that states get the level of funding they need for every child.

The future of our nation’s children is on the line right now, from soybean farms in Illinois to Pennsylvania’s coal country, and from the president’s home of New York City to towns in the Mountain West. Children cannot lobby or vote. Our society has a responsibility to ensure that children are not harmed as the nation considers changes to the Medicaid program. If we get it wrong, we will jeopardize their health and potentially increase the ultimate costs of their care.

 

Patrick M. Magoon

President and CEO

Ann & Robert H. Lurie Children’s Hospital of Chicago

 

Matthew M. Davis, MD, MAPP

Head of Academic General Pediatrics and Primary Care

Ann & Robert H. Lurie Children’s Hospital of Chicago

Professor of Pediatrics, Northwestern University

 

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