Over the last week, many health care providers and policy makers have weighed in on the latest health care reform efforts in the Senate. All point to proposed Medicaid caps, which go well beyond the Affordable Care Act (ACA) and undermine well-established paths to coverage for children and families that were in place well before the ACA became law.
In mid-June, a bi-partisan group of Governors urged Senate leaders to focus on improvements needed in the ACA marketplaces and to, in essence, keep contentious Medicaid changes off the table. They wrote:
The House-passed bill] calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states. Medicaid provisions included in this bill are particularly problematic. Instead, we recommend Congress address factors we can all agree need fixing.
The National Association of Medicaid Directors today raised concerns about similar proposed caps in the Senate bill. Their statement reiterates the point that any new flexibility that accompanies significant cuts would merely result in “flexibility” to make bad choices:
[…]no amount of administrative or regulatory flexibility can compensate for the federal spending reductions that would occur as a result of this bill […] It would be a transfer of risk, responsibility, and cost to the states of historic proportions.
Other major health groups are also voicing concerns. Last week the American Academy of Pediatrics wrote about how the Senate bill, in particular, would undermine health care for children. Don’t pediatricians know best about what health care kids need? Here’s what they had to say:
Pediatricians understand that Medicaid is not just an entitlement program; it’s an empowerment program. Medicaid allows a college student with cerebral palsy to live independently. Medicaid pays for a toddler’s wheelchair, and as she grows over time, it covers the next one and the one after that. Medicaid is there for families struggling from the opioid epidemic, covering treatment for parents and services for their children. Medicaid covers a grandmother’s chemotherapy and a newborn baby’s emergency heart surgery and a six-year-old’s hearing screening and a teenager’s asthma inhaler.
The bill that the Senate unveiled today was crafted without the benefit of groups like pediatricians weighing in with what children need. The result is that the bill would tear down the progress we’ve made by achieving health insurance coverage for 95% of America’s children.
Of course, many parent, child and consumer groups note the problems with the Medicaid proposals too. But perhaps the highest profile parent to weigh in, Jimmy Kimmel, tweeted reminders that the new bill does not pass the “Jimmy Kimmel Test.” The best way to truly “do no harm” would be to leave Medicaid’s current structure in place with no cuts.