While our attention has been necessarily focused on extending CHIP funding (and working on the best ways to take advantage of the funding boost that came with it), Congress is engaged in another exercise that demands the attention of children’s health advocates. As in recent years, Medicaid is on the chopping block during budget negotiations, and while details are scarce, signals suggest attempts (again) to attempt major cuts to the program.
By way of background, last month the House and Senate agreed to a budget resolution—a non-binding framework that sets the total amount of spending and a policy agenda– for the federal fiscal year 2016 budget. Among other things, the resolution aims to repeal the ACA and reform Medicaid. Included in this agreement is use of the budget reconciliation process, which essentially allows Congress to pass a budget without a lot of procedural hurdles (i.e. filibuster and lots of amendments) and simple majority vote.
Congress will likely get to work on budget reconciliation when they return after July 4th. The budget resolution calls for “Medicaid reforms” which would likely set in motion a plan to cap Medicaid spending through a block grant or via its more innocuous-sounding cousin – the per capita cap. As my colleague Sean Miskell has pointed out, this is a bad remix of the same old tune. Such proposals to use Medicaid as a means to find cost savings (read: cuts) would undoubtedly result in shifting costs to states and undermining coverage and care for millions of Americans. With President Obama in office, we will likely see a veto of any measure that includes such extreme proposals. But there is always the risk of some level of Medicaid cuts becoming part of any budget agreement.
Those who wish to slash Medicaid funding seem to have lost sight of the fact that cuts to Medicaid would inevitably harm children, as they are by far the largest group of Medicaid beneficiaries making up nearly half of program enrollment. As the info-graphic from the Kaiser Commission shows (see below), 37% of the nation’s children rely on Medicaid, and more than three-fourths of children under the federal poverty line (FPL) are enrolled in the program. Cuts to Medicaid would undermine the coverage and economic security for millions of children and their families.
Say Ahhh! readers know well that Medicaid is the MVP (and CHIP a crucial player) in our nation’s historic success in reducing the uninsured rate for kids. Between 1997 and 2012, children’s uninsurance rates were cut in half. But that’s not all…mounting evidence underscores the long-term positive effect of childhood Medicaid coverage for children as they grow into adults. More and more studies are documenting the long-term positive effects of Medicaid —children become healthier adults who have higher rates of success in terms of education, financial security and later earnings. (A recent blog post by Matt Broaddus at the CBPP highlights some of this exciting new research.)
Here’s the thing: We just saw Congress vote overwhelmingly on a bipartisan proposal to extend CHIP and protect health coverage for 8 million kids. Why on earth would Congress reverse course now and undermine strong coverage for nearly 40 million kids in the same year?
Helping low-income families pay bills, promoting healthy child development, building strong communities, giving children the best opportunity to reach their full potential – these all depend on a strong, well-funded and stable Medicaid program. Revamping its structure in the name of savings would only hurt kids now and jeopardize their future.
