THE QUARTERLY PUBLICATION OF THE AMERICAN COLLEGE OF OSTEOPATHIC PEDIATRICIANS
Summer 2017 Issue
to Home Page
ACOP Policy Update
Spare the Rod and Spoil the Child: Endangered Medicaid Funding and the Importance of Supporting Programs that Support our Nation’s Children
By Frederick Stine, VI, DO, MHA
Much of the health care policy landscape has been in flux with the May 4th passing by the House of the American Healthcare Act (AHCA), a GOP-proposed repeal-and-replacement law of the Affordable Care Act of 2010. As the bill transits to the Senate, many Republicans in that chamber have said that the House-authored AHCA will not be the ACA-replacement bill that the Senate ultimately produces.(1) However, the relative stealth(2) with which Senate GOP leaders are crafting an overhaul of the House bill leaves little room for optimism that the Senate will spare many of the entitlement programs like Medicaid & Medicare, targeted by the initial bill. With there being much cross-talk about cutting the high costs of healthcare and what that means for everyday Americans, it is increasingly important for Pediatricians and child/family advocates to be able to read between the lines about how this will affect our patients.
By the end of May 2016, the number of children enrolled and actively receiving benefits from the Children’s Health Insurance Program law, otherwise known as CHIP, almost surpassed 8.5 million.(3) CHIP is a law vital to the health of the children of this nation, as it effectively bridges the healthcare coverage gap for those children aged 0-19 whose family’s income is too high to receive Medicaid but too low to afford private insurance.(4) While this integral law was intended to “sunset” in 2015, it was virtuously continued under the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) and, to advance the good work of this effective and successful law, the current administration has agreed to extend MACRA for another two years through the end of FY 2019. Using this as an indicator, it appears as if this administration is prioritizing the neediest children in our society.
However, the devil is truly in the details. While MACRA and its CHIP provisions will continue to cover children who don’t qualify for Medicaid, it is important to note that Medicaid itself, free of CHIP, provides insurance for the majority of uninsured children in the United States, covering some 36.1 million children nationwide(5) whose family income is up to 138% of the Federal Poverty Level (FPL). Combine this data with recently proposed cuts to Medicaid in the AHCA of up to $800 billion(6) and proposed restructuring of Medicaid state-allocations to either block grants or per capita caps,(7) and its plain to see how the current political head-winds could endanger the health and well-being of many of our nation’s most vulnerable children and families.
According to the Georgetown University Health Policy Institute Center for Children and Families, slashing and capping federal Medicaid benefits for children could have the effects of jeopardizing the guarantee of coverage, altogether removing the guarantee of benefits, could put states and families at risk during economic downturns, weaken states’ abilities to respond to public health crises, put undue pressure on other children’s programs in state budgets, and effectively disallow the states from assisting needy families and children when the peripheral costs (i.e.- pharmaceuticals, diagnostic testing, etc.) of medical care rise.(6)
With this in mind, it is imperative for lawmakers to weigh the intergenerational consequences of such drastic cuts to the programs that support the provision of healthcare for almost half of the entire pediatric population of our country.(8) It is equally imperative for physicians, allied health workers, and other patient advocates to be vocal on the state and federal level about the importance of continuing funding for MACRA and also for Medicaid at least until a restructuring effort that does not harm our nation’s most vulnerable children can be established.
References:
-
Costa, R., & Wagner, J. (2017, May 7). As some Republicans rush to defend House health bill, Senate GOP warily pauses. Retrieved June 18, 2017, from https://www.washingtonpost.com/politics/as-some-republicans-rush-to-defend-house-health-bill-senate-gop-warily-pauses/2017/05/07/47cde200-3346-11e7-b412-62beef8121f7_story.html?utm_term=.09628cc33c77
-
Davis, S. (2017, May 15). Secret Republican Senate Talks Are Shaping Health Care Legislation. Retrieved June 18, 2017, from http://www.npr.org/2017/05/15/528449558/secret-republican-senate-talks-shaping-health-care-legislation
-
The Henry J. Kaiser Family Foundation. (2017, March 24). Total Number of Children Ever Enrolled in CHIP Annually. Retrieved June 18, 2017, from http://www.kff.org/other/state-indicator/annual-chip-enrollment/?activeTab=graph¤tTimeframe=0&startTimeframe=10&selectedRows=%7B%22wrapups%22:%7B%22united-states%22:%7B%7D%7D%7D&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
-
Dworetzky, A. (2016). Infographic: Medicaid & CHIP: What’s the Difference? Retrieved June 18, 2017, from http://cahpp.org/wp-content/uploads/2016/06/medicaid-chip-infographic.pdf
-
Cornachione, E., Rudowitz, R., & Artiga, S. (2016, July 13). Children's Health Coverage: The Role of Medicaid and CHIP and Issues for the Future. Retrieved June 18, 2017, from http://www.kff.org/health-reform/issue-brief/childrens-health-coverage-the-role-of-medicaid-and-chip-and-issues-for-the-future/
-
Burak, E. (2017, February). How Restructuring Medicaid Could Affect Children. Retrieved June 18, 2017, from http://ccf.georgetown.edu/wp-content/uploads/2017/02/Medicaid-funding-caps.pdf
-
Federal Interagency Forum on Child and Family Statistics. (2016). America’s Children in Brief: Key National Indicators of Well-Being, 2016. Retrieved June 18, 2017, from https://www.childstats.gov/pdf/ac2016/ac_16.pdf
PULSE IS AVAILABLE ON YOUR SMARTPHONE AND TABLET!
JOIN ACOP TODAY!
REGISTER NOW!
ACOP Pediatric Track at OMED 2017
October 7-10, 2017
Philadelphia, PA