By Jocelyn Guyer

Yesterday, House Budget Committee Chairman Paul Ryan (R-WI) released a lopsided budget plan that harms the most vulnerable and protects the most secure.

It would radically alter Medicaid and shift costs to the states by changing Medicaid to a block grant and deeply slashing federal funding for the program by $771 billion over the next ten years.  Along the way, it also would repeal health care reform (bringing the total size of the Medicaid cuts to $1.4 billion) and turn Medicare into a privatized voucher program while protecting corporate tax breaks and extending tax cuts to the wealthy.  For children, this is an extraordinarily high stakes debate.  Medicaid, together with CHIP, has been a core component of the nation’s success in covering children and the future of this program is key to the future of our nation’s children.

• Medicaid, along with its companion program, CHIP, covers close to one in three of America’s children and is largely responsible for the nation’s success in driving uninsured rates down to the lowest level on record. Many of these children are in low and moderate-income working families who lack access to affordable coverage through their parents’ jobs.  They rely on Medicaid for flu shots so their kids can stay healthy.  They look to it for hearing tests and glasses so their children can grow and learn, as well as for physicals so they can play sports.  In many families, Medicaid provides children with the medical care that they need so they can thrive in the face of common medical conditions such as asthma and ADHD.
• For special needs children, Medicaid is an essential life-line.  While most children covered through Medicaid are quite healthy, a small number (3.6 million) are some of the most vulnerable children in America – children living with autism, Downs Syndrome, cerebral palsy or other disabilities or who have to turn to Medicaid to cover their cancer treatment.  For example, Medicaid pays for close to half of all NICU care and of all hospitalizations of infants born with birth defects.  For many of these children, Medicaid offers lifesaving care and allows them to be raised at home. 

In its initial analysis of the proposal, the Congressional Budget Office has estimated that under Ryan’s plan “federal spending for Medicaid would be 35 percent lower in 2022 and 49 percent lower in 2030 than currently projected.”  (In this instance, they effectively left aside health reform and considered only what would happen to projected spending for the current Medicaid program).  In its usual staid style, CBO goes on to note that these cuts are of such a magnitude that states will probably need to cut spending on other programs; increase taxes; reduce payments to providers; reduce the scope of benefits; or limit eligibility.  To put it less staidly, the proposal would be devastating to the nation’s children, who make up the majority of people covered by Medicaid.