Almost every kid in our state has medical coverage, a health-care mountaintop that took decades to reach. The Republican health-care bill would bring that crashing back down.
Lelach Rave, a pediatrician at the Everett Clinic, recently met with the staffs of some Republican members of Congress. Her message: Don’t turn her patients, all of whom are kids, into collateral damage in the Obamacare fight.
“They were adamant to me, saying, ‘Of course we’re not going to cut any kids off health care,’ ” Rave said, after meeting with Spokane Rep. Cathy McMorris Rodgers’ office this month.
But now that the GOP repeal plan is here, it turns out it contains a stunning $880 billion cut to Medicaid, the government health program for the poor. That’s a 25 percent reduction over 10 years, a cut on a scale never before attempted in one of the big three entitlement programs (the other two are Social Security and Medicare).
Lost in translation, somewhere between here and Congress, is that about half of all kids in Washington state are on Medicaid. Of 1.6 million children, 836,000 here get clinic visits and other care financed through a state-federal partnership (called Apple Health for Kids), with most of that money coming from Medicaid.
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“I’m not sure if Congress is aware how many kids here are on Medicaid — when I told them this, they just kind of looked at me,” Rave said. “It isn’t a sliver.”
Yet the question of what happens to kids in the GOP repeal of the Affordable Care Act has scarcely been brought up. One study, by the Urban Institute in January, found that repealing Obamacare similar to the way the GOP is now doing it would cause about 100,000 kids in Washington to fall off medical coverage.
It wouldn’t happen automatically — there is no “cut poor kids off health care” line item in the bill. But a federal cut of this magnitude would “destabilize the main financial pillar we have used to cover so many kids in Washington,” says Jon Gould, deputy director of the Children’s Alliance in Seattle.
“We’re very alarmed,” he added. “We’re not sure Congress understands the implications of what they’re about to do.”
Maybe they don’t. But it seems a pretty predictable outcome: That slashing the primary national program for children’s health might hurt some of them?
The irony is that Trumpcare is barreling at us right as the state finally reached a sort of health-care mountaintop. At the end last year, 98 percent of kids here had medical coverage. That’s considered as close to complete coverage as you can get, because there will always be some fraction of families living off the grid or resistant to the medical system.
“It took about a 15-year effort to get here,” Gould says. “Now this. This would be a major step backward.”
The Urban Institute study estimated the uninsured rate among kids here could rise from 2 percent back to 8 percent — which is what it was before Obamacare lured thousands of working-class families to sign up for the Medicaid expansion.
If the repeal bill passes, the burden to cover them would shift to a state that already can’t seem to pay its bills (it’s being fined $100,000 a day for failing to do so with the schools.)
“It’d be up to the state how to respond, but with a 25 percent Medicaid funding cut there’s not much doubt that some kids would be losing coverage,” Gould said.
Remember when Donald Trump boasted he was the only GOP candidate who wouldn’t cut Medicaid? He said it repeatedly, and even put it in writing. The gall of this flip-flop, coming so soon after he took office, combined with the huge impact it will have on people’s lives, well it takes the breath away.
Last week I wrote about how unusual it was that Congress was going after old folks in its health-care bill. But old people fight back. AARP started barraging Congress with both lobbying and ads. And this week the GOP put in some money for bigger tax credits for the nearly senior set.
But for kids? The cuts to Medicaid only deepened. That’s the thing about kids: They don’t vote.