The Atlantic

By: Adrienne Lafrance

The Affordable Care Act managed to provide insurance to more than 95% of America’s children nationwide, thanks to its programs such as Medicaid and Children’s Health Insurance Program. However, the American Health Care Act proposed by the Republican party to replace the Affordable Care Act will eliminate this progress, since they plan to decrease the federal funding for Medicaid by $880 billion.

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“There are incredibly high stakes for children in not only the current health-care debate but in debates that lie very shortly ahead—on the future of the Children’s Health Insurance Program and, more importantly, Medicaid,” said Joan Alker, the executive director of the Georgetown Center for Children and Families, a nonpartisan health-care policy and research center. Part of the reason the Affordable Care Act was so important for kids, Alker told me, is because it enabled their parents to get insurance, “and a healthier parent is a better parent.”

It’s “no surprise that the massive cuts proposed in the bill are coming out of Medicaid and not Medicare—even though candidate Trump [said] he wouldn’t cut either of these programs,” Alker told me. “Children are the largest single group of beneficiaries on Medicaid and they don’t vote.”

“There has been very little oxygen in the debate focused on children,” she added. That’s despite the fact that nearly 40 percent of all American children are covered through Medicaid or CHIP. An even larger percentage of children with special health-care needs rely on such programs for access to care. “Medicaid is something that most American families may need at some point for one reason or another except for those at the very top,” Alker said. It’s “the nation’s largest health insurer for children and pregnant women.”

In other words, just making sure that kids are eligible for coverage isn’t enough. They have to enroll. And insurance has to be affordable enough that paying for it doesn’t stretch families too thin. That’s why many policy experts are concerned about giving states the flexibility to implement cuts to Medicaid. Flexibility, in this case, could mean new enrollment caps, or rules about work requirements, or other measures that reduce participation in programs like Medicaid. Governors can’t implement Medicaid cuts without “direct cutbacks in the health-care that the 70 million Americans on Medicaid rely upon,” Alker wrote in a blog post.

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