By Dr. Dipesh Navsaria, Dr. Gail S. Allen, Dr. Elizabeth J. Neary and Dr. Ellen R. Wald – Wisconsin pediatricians

You may wonder why pediatricians are writing in support of accepting federal funding under the Affordable Care Act to expand Medicaid to higher eligibility levels. After all, in Wisconsin most children under age 18 are eligible for health care coverage via Medicaid or BadgerCare. Our interest in expanding health coverage is based on the very simple fact that children live in families. Due to proposed changes announced last year by Gov. Scott Walker, parents of children will lose their coverage.

These changes will increase the number of childless adults eligible for BadgerCare — but at the cost of removing an almost equal number of working parents from coverage. While this may seem an even exchange at worst, parenting can be challenging under the best of circumstances. When a parent suffers from untreated chronic illness, both the parent and child suffer.

A recent clinic visit by a child with school problems highlighted this issue. Despite an uninsured mother’s best efforts to help her child, her exhaustion from her uncontrolled diabetes limited the time she was able to spend with her son on his nightly homework. Her employer did not provide health insurance. She asked for help, because if her health was better she would gladly follow through with any and all recommendations and medications. Unfortunately, we had no additional viable coverage options to offer her. Clearly, lack of health insurance harms parents and their children.

According to the nonpartisan Legislative Fiscal Bureau, by expanding Medicaid, an additional 175,000 Wisconsinites could be covered, resulting in nearly $66 million in state savings in the first three years, with nearly 10 times that amount coming in the form of federal dollars. The current rejection of Medicaid expansion will result in a total projected loss of $1.8 billion by 2022.

Some may wonder why it is necessary to support families who are above the poverty line. The federal poverty line is calculated based on an outmoded formula and is unrealistically low. Most would consider twice that number to be a more reasonable estimate of what is needed to adequately provide for the very basic needs of parents and children.

Historically, Wisconsin has done a better job than most in caring for its citizens. Our inclusive BadgerCare program covered people with incomes up to 200% of the federal poverty line. (Notably, Wisconsin is receiving an over $13 million bonus for excellent coverage for children through this program.) By rolling this back to 100%, we are regressing, not advancing the goal of covering our population. The Affordable Care Act provides a clear pathway to providing coverage, but we are going in the opposite direction instead.

The argument has been made that these now-uninsured parents can be moved into the health insurance exchanges set up under the Affordable Care Act. According to the Kaiser Family Foundation, this is probably not viable for adults who are just over the poverty level for two reasons: 1) If an employer-sponsored health insurance plan is offered, they won’t be eligible for exchange subsidies even if the premiums, co-pays and deductibles are relatively high; 2) The cost-sharing plan that was developed was never intended to apply to families close to the poverty level. The intent of Congress was to have families just over the poverty level covered through universal Medicaid expansion. By accepting federal funding to expand Medicaid under the Affordable Care Act, we could cover working parents as well as childless adults.

To care for your children and provide for them is both the ultimate task and ongoing joy of parenting. By removing clear and consistent coverage for parents in Wisconsin, we are reducing the odds that they can be the great sources of support they want to be for their children. Children and families in Wisconsin deserve better. Our public policy needs to support acceptance of federal funding for Medicaid expansion. It matters.

This post originally appeared in the Milwaukee Journal Sentinal.