The great news that we should all celebrate is that children are healthier than they have ever been in human history. This is largely due to advances in public health, medicine, vaccines and antibiotics over the past 100 years that have allowed us to prevent or treat many life-threatening diseases and chronic conditions. Now is not the time to sacrifice these incredible gains. Yet, the health care proposal being fast-tracked through Congress this month is threatening the health and welfare of our most precious resource: our children and grandchildren.
Members of Congress have promised to do a lot, just as their predecessors did eight years ago when they fast-tracked the Affordable Care Act for President Barack Obama’s signature. In the quest to “repeal and replace” Obamacare, the plan being considered by Congress goes much further. The American Health Care Act proposes to fundamentally change access to health care in our country by changing Medicaid from a program which provides funds based on individual health needs to a population-based formula that would provide a fixed amount of funds to each state annually, regardless of needs. According to the Congressional Budget Office, this would reduce the federal expenditure on medical care by $337 billion over the next 10 years. However, this would force state legislatures to make cuts to Medicaid for health care costs that could not be covered without federal funds, placing the onus of rationing health care on our legislators. While $337 billion over 10 years is a very large amount of money, it represents less than 4 percent of the more than $930 billion annual federal expenditure on health care and less than 1 percent of the total federal budget annually. We are talking about saving pennies and nickels through the loss of insurance coverage for more than 15 million Americans. Uninsured persons will still require medical care, and often receive it at a later stage in their illnesses, the costs of which will be borne by the states.
Medicaid and the Children’s Health Insurance Plan provide health insurance for more than 760,000 children in Louisiana, assuring access to healthcare for approximately 45 percent of the children in our state. This has nothing to do with Obamacare, since Medicaid has been the primary insurance for poor children from working families for more than 50 years. As such, Medicaid has provided critical access to health care for millions of Louisiana’s children over the past five decades. Medicaid and CHIP now account for 55 percent of all federal funds to Louisiana each year . . . funds that are a significant part of our annual state budget. While over 50 percent of Medicaid recipients are children, only 23 percent of the Medicaid dollars are used to pay for children’s health care and preventative services in Louisiana. The remaining 77 percent of Louisiana Medicaid funds are used to provide care for disabled adults and nursing home residents, populations that are expected to grow over the next 20 years with the aging of the Baby Boomer generation.
The promised “increased flexibility to states” that is being discussed in Washington is not about allowing states to pay less to doctors and hospitals. States already have this flexibility and they have used it quite often over the past decade. No, the “flexibility” that will be offered to states is the ability to eliminate or cut key components of the Medicaid core services, such as screening for lead poisoning, assessment of infant and child development, screening for dental, hearing and vision problems, diagnostic tests required to evaluate new problems and treatment of medical and mental health problems, effectively “kicking the can down the road” just like the recently reported $2 billion in “deferred maintenance” on our college campuses in Louisiana.
Healthy children learn better and grow up to be productive healthy adults. Now is a crucial time for all parents, grandparents and state legislators to speak up for our children. Let’s not jeopardize the health of the next generation by letting Congress play political football with our children. Louisiana has enough problems to worry about already.
Dr. Bryan G. Sibley of Lafayette is president of the Louisiana Chapter of the American Academy of Pediatrics. Dr. John A. Vanchiere of Shreveport is the chapter's vice president.