GOP health bill would hit children hard, study says
Most of the debate on the GOP health care legislation in Congress has focused on how it would affect adults, in high-profile areas such as coverage, mandates, and premiums.
But a new Brandeis University study emphasizes that the proposal would also have a large impact on children’s coverage.
The study estimates that 4.7 million school-aged children, including 175,000 in Georgia, could lose Medicaid coverage under the American Health Care Act.
Black and Hispanic children would be disproportionately affected, according to the study, released last week.
The legislation recently passed the House and is being discussed in the Senate. It would replace the current federal health law, known as the Affordable Care Act or ACA.
Republicans say getting rid of the ACA is necessary, pointing out that premiums in the ACA-created insurance exchanges have been increasing at a high rate, while insurer options have shrunk.
The Congressional Budget Office, meanwhile, estimated that the Republican legislation would lead to 23 million more Americans becoming uninsured. “I’m deeply concerned and troubled by the proposed cuts to Medicaid,’’ says Dr. Melinda Willingham, a Decatur pediatrician, responding to the study’s conclusions. She works in a group practice where 65 percent of the children served are on Medicaid. If more children become uninsured, she says, many of them may go without immunizations and needed medications. Many also would not receive dental care and mental health services, she adds.
The Brandeis study’s authors point to the GOP bill’s goal of returning the federal income eligibility limit to 100 percent of the federal poverty level (now $20,420 for a family of 3) for children ages 6 to 19,down from the current 138 percent threshold under the Affordable Care Act.
After 2019, states will have the choice of either maintaining above-federal enrollment levels, or of cutting enrollment levels down to lower levels closer (or equal) to federal minimum standards, the study’s authors said.
The decline in the number of black children eligible in Georgia would be 74,024, the second-largest decline in the country, the study says. States with the largest declines in the number of black children eligible for Medicaid under the AHCA include Florida (88,200); Georgia (74,024); Texas (66,872); North Carolina (52,628); and New York (48,449). The decline in the percentage of black children eligible in Georgia would be 12 percent.
The decline in the number of Hispanic children eligible in Georgia is estimated at 40,700. The states with the largest declines in the number of Hispanic children eligible for Medicaid under the AHCA include California (462,474); Texas (358,479); Florida (118,852); New York (90,639); and Arizona (71,580). Georgia ranks 8th. The decline in the percentage of Hispanic children eligible in Georgia would be 16.4 percent.
Willingham says she fears further budget cuts if Medicaid goes to a “block grant” program, as proposed under the Republican legislation, which would cap federal spending on the program while giving states more flexibility over the program.
The study’s authors said “states will be exercising their new set of options in the context of reduced overall Medicaid funding.’’
Medicaid currently covers about 2 million Georgians, most of them children.
Half of the children in Georgia benefit from Medicaid each year, says Erica Fener Sitkoff, policy director for Voices for Georgia’s Children, an advocacy group.
“We have and continue to have concerns that all Georgia’s children do not have the same access to quality health care,’’ Fener Sitkoff says. “Unfortunately the plans put forth thus far would not improve the situation. In fact, current proposals place Georgia at an even greater deficit. Considering we currently have 166,000 uninsured children . . . further cuts of any sort will significantly compromise the health and safety of our children and youth.
The study was conducted by the Institute for Child, Youth and Family at the Heller School for Social Policy and Management at Brandeis.
A loss of health coverage could put children’s educational and economic opportunities at risk, says Laura Colbert of Georgians for a Healthy Future, a consumer advocacy group.
The Republican legislation, if enacted, “would have an especially big impact on children of color in our state,’’ Colbert adds. “We already see health disparities in communities of color in terms of shorter life spans and higher rates of chronic diseases. Coverage losses among primarily children of color would widen those gaps.”