The continuing assault on our children’s health

MARIAN WRIGHT EDELMAN | 10/2/2017, 5:38 a.m.
It’s back. The assault on our children’s health coverage has been resurrected for a final last-minute attempt at passage and ...

Children’s Defense Fund

It’s back. The assault on our children’s health coverage has been resurrected for a final last-minute attempt at passage and is even more dangerous and cruel than ever. The latest Graham, R-S.C., and Cassidy, R-La., revision of the health repeal bill would feel like a Halloween movie cliche with a zombie-like villain that refuses to die if its threats to children, seniors and more of America’s most vulnerable weren’t so deadly serious.

It almost defies belief that after repeated failed attempts Republican senators are trying once again not only to take away the benefits to children, families, other adults and seniors included in the Affordable Care Act, which has helped insure nearly 20 million people, but they are reaching beyond the ACA to dismantle Medicaid. Medicaid’s safety net has been in place for 50 years under presidents of both parties and is a lifeline for 37 million children, covering almost half of all births and more than 40 percent of children with special health care needs. It also ensures coverage for low-income adults including those with disabilities and covers two out of three nursing home beds. Over these many months, even the most rabid “repeal and replace” politicians didn’t campaign on getting rid of the ACA and its protections without replacing it, and even President Trump vowed there would be no cuts to Medicaid. But like the earlier “repeal and replace” health bills that failed to pass, this bill repeals the ACA without replacing it, dismantles Medicaid and is even more egregious than its harsh predecessors.

Here are some ways the cruel Graham-Cassidy repeal bill threatens children, parents, other adults and seniors:

It ends Medicaid as we know it with a massive cost shift to states by imposing a per person cap on federal spending, regardless of need or unexpected costs like the opioid epidemic, rising drug prices or recent hurricanes or other natural disasters. States would have to pay all costs in excess of the cap, or more likely – since it would become increasingly impossible for states to fund the gap that grows bigger and bigger over time – make huge cuts in eligibility, benefits and provider payments that will most certainly leave children and other vulnerable populations worse off. Education agencies will be left with many fewer Medicaid dollars to help school systems assist children and youths with disabilities, and child welfare agencies will have to struggle to ensure health care for children and youth in foster care who have the state as parent and children with special needs adopted from foster care.

Replaces the ACA’s marketplace subsidies and Medicaid expansion with a block grant funded well below current levels. These federal funds would end altogether after 2026, resulting in more people losing coverage. States would have broad authority to spend block grant funds on any health care expenses with no requirement that dollars help low- and moderate-income Americans get health coverage.

Allows states broad waiver authority to exclude coverage of essential health benefits including mental health, substance abuse treatment and maternity care. It also allows states to return to the day when insurance companies were allowed to charge higher premiums based on health care status, allowing again discrimination against children and adults with pre-existing conditions.