GOP health bill would hit chil­dren hard, study says

Walker County Messenger - - News - By Andy Miller

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.”

Melinda Willing­ham

Laura Col­bert

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