Commentary: Bill ending Medicaid guarantees puts children in jeopardy


In 1965, the federal government made a promise to children with disabilities and from low-income families: They would have health coverage. In 2017, the federal government is about to break that promise. The Better Care Reconciliation Act of 2017 jeopardizes children’s access to health care because it no longer guarantees health coverage through the Medicaid program. Instead, the bill caps the federal government’s funding for children’s health care, leaving innocent children, who cannot control what family they are born into or what ailments they are born with, at the mercy of appropriators.

While the bill does take some positive steps toward protecting children, including exempting children with disabilities from per capita caps, those children are still at risk. Once the federal government limits Medicaid funding, states will need to make up the difference or limit the services or the number of Medicaid enrollees to stay under the federal cap. And they are likely to do this through across-the-board cuts, which will affect all Medicaid enrollees, including children with disabilities.

LIKE US ON FACEBOOK: Our Viewpoints page brings the latest commentaries to your feed.

There are 30 million children in the United States enrolled in Medicaid, more than 40 percent of the nation’s kids and nearly half of all Medicaid beneficiaries. This includes 3 million children in Texas, or almost half of the children in the state. Yet children don’t drive Medicaid costs; children without disabilities make up about 70 percent of the Medicaid caseload in Texas but account for only 30 percent of the spending.

To children’s hospitals in Texas, these are not just statistics. These numbers represent the children and families our member hospitals see in their emergency rooms and hospitals each day. Our hospitals are the pediatric safety net for all Texas children, with services and expertise specifically designed for kids. In fact, in 2014, more than 14,000 patients in children’s hospitals were transfers from other medical facilities that could not provide the necessary pediatric care those children required.

Medicaid provides a safety net for working families that have children with complex medical conditions. The program helps shoulder the financial burden not covered by commercial insurance, ensuring that these families are not devastated financially.

Children with access to Medicaid are more likely to attend school, graduate from high school and go to college, becoming healthier adults who will earn more and pay more in taxes than those who do not have appropriate health care as children. Dramatic changes or across-the-board cuts to Medicaid will hurt coverage for children and decrease their ability to access appropriate and timely health care.

Thanks to the efficiency of the program, growth in per capita Medicaid expenditures in Texas falls below both commercial insurance and Medicare levels. When adjusted for inflation, Texas is spending less per Medicaid enrollee than the state did in 2001.

MORE VIEWPOINTS: The Statesman’s editorial writers tackle local and national issues.

Due to the high number of children enrolled in Medicaid, children’s hospitals rely heavily on it to pay for patient services. For the eight member hospitals of the Children’s Hospital Association of Texas, between 50 percent and 80 percent of their admissions are Medicaid patients. And even at current funding levels, the actual cost of care exceeds the amount that Medicaid pays. Many hospitals must absorb the cost for poor children who are not insured or are underinsured.

Children’s hospitals support families from before birth through the end of life, from prenatal care and genetic counseling through palliative and hospice care. Congress should support American families by continuing to guarantee Medicaid coverage for all children and pregnant women. Taking this pro-family approach will fulfill Medicaid’s original purpose of providing health coverage to children with disabilities and from low-income families. Congress should not break its 50-year commitment to ensuring that children have access to health care to get their best start in life.

Wilson is the president of the Children’s Hospital Association of Texas.



Reader Comments ...


Next Up in Opinion

Letters to the editor: Sept. 24, 2018
Letters to the editor: Sept. 24, 2018

Re: Sept. 18 article, “Searching for new wedge issue, Cruz says O’Rourke will ban barbecue.” Despite marrying a California vegetarian who has dyed her hair, and despite using technology, hypocritical Cruz acts as though these ideas are anathema to him and foreign to Texas. Does Cruz know that Texas farmers grow over 5 million bushels...
Opinion: What the Times misses about poverty

It’s an affecting story. Matthew Desmond, writing in The New York Times Magazine, profiles Vanessa Solivan, a poor single mother raising three children. Vanessa works as a home health aide, yet she and her three adolescent children are often reduced to sleeping in her car, a 2004 Chrysler Pacifica. In the morning, she takes her two daughters...
Opinion: Days of fear, years of obstruction

Lehman Bros. failed 10 years ago. The U.S. economy was already in a recession, but Lehman’s fall and the chaos that followed sent it off a cliff: Six and a half million jobs would be lost during the next year. We didn’t experience a full replay of the Great Depression, and some have argued that the system worked, in the sense that policymakers...
Facebook comments: Sept. 23, 2018
Facebook comments: Sept. 23, 2018

As reported by the American-Statesman’s Chuck Lindell, Republican Pete Flores defeated Democrat Pete Gallego in Tuesday’s runoff election for Senate District 19, which stretches from San Antonio to the Big Bend region and the New Mexico border. At Flores’ campaign victory party in San Antonio, Lt. Gov. Dan Patrick told supporters...
Rivalry turns deadly in David Pinto’s compelling, unpredictable ‘Nemesis’
Rivalry turns deadly in David Pinto’s compelling, unpredictable ‘Nemesis’

A friendly rivalry turns deadly in “Nemesis” by David Pinto. Elliot Barrett’s life is an enviable one. He’s a prestigious physician with a thriving practice, a well-appointed home in New York City, a devoted wife, and two loving children. He risks it all when he becomes romantically involved with Lindsey Anderson, the seductive...
More Stories