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Op-ed: Proposed Medicaid cuts threaten children and require more analysis

Published May 5, 2017 6:36 pm
This is an archived article that was published on sltrib.com in 2017, and information in the article may be outdated. It is provided only for personal research purposes and may not be reprinted.

Our congressional leaders face a rare opportunity to course-correct in a way that directly saves lives.

With all the debate about health care reform and the proposed American Health Care Act (AHCA), our representatives can ensure our most precious resource — the health of our children — is a priority. In making choices about the allocation of health care funding, it is critical we don't lose sight of our children and youth. While they represent a small share of the nation's health care expenditures relative to adults, children's access to appropriate services is critical for their development and for the future of our country.

The Medicaid program, enacted in 1965, and the Children's Health Insurance Program (CHIP) — which was enacted thanks in great part to the leadership of Utah's Sen. Orrin Hatch in 1997 — dramatically improved health care for children. These programs provide critical access to care for more than 45 million lower-income children and adolescents across our country — and more than 200,000 of these children live in Utah. As a result of these programs, from urban centers to rural areas, the rate of uninsured children across our state dramatically decreased from 14 percent in 1997 to 5 percent in 2016, leading to significantly improved health outcomes.



Unfortunately, in the current debate about the AHCA and possible revisions to Medicaid, almost nobody is talking about the 30 million children covered by Medicaid and the disproportionate negative impact on children from Medicaid cuts. Nationally, about 43 percent of Medicaid beneficiaries are children, but they account for only 20 percent of the expenditures. Here in Utah, children are 59 percent of Medicaid's beneficiaries but the children's category makes up only 31 percent of Utah Medicaid expenditures. There is another group of children in Utah's Medicaid program that is classified as part of the disabled category of Medicaid beneficiaries — if you include them, children make up 66 percent of Utah's enrollees. In Washington, it seems, zero percent of the discussion is about children. This needs to change.

The most recent estimate from the Congressional Budget Office (CBO) projects that the AHCA will reduce overall federal Medicaid funding by $880 billion (or 25 percent) over the 2017-2026 period, causing the number of uninsured Americans to increase by 24 million over the next decade and effectively shifting significant Medicaid costs to the states. Many say that children will be fine because they have CHIP. This is not the case. We are alarmed about the effects the proposed cuts will have on children's health, and the conspicuous lack of information on the impact on children should be a red flag to legislators who would push the AHCA forward in its present form. Clearly, additional examination of these issues is needed.

Congress has the opportunity to preserve and even enhance the gains made in children's health care. Legislators can ensure all funding for children, including those children in the disabled category, is clearly identified and preserved. They can continue requirements that all children have full access to pediatric-specific benefits providing medically necessary care as determined by their physicians. They can help all children have a future by preserving access to health care.

Children's health should not be a partisan issue. We urge Congress to take advantage of this opportunity and carefully consider and prioritize the health of children as they proceed in this important national debate.

Marc Harrison, M.D., is a pediatrician and president and CEO of Intermountain Healthcare. Katy Welkie, R.N., is CEO of Intermountain's Primary Children's Hospital.

 

 

 

 

 

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