Health-care reform can’t punish children

Medicaid expansion under Obamacare would be phased out under the Senate’s version of the health-care reform bill released Thursday, fundamentally altering the core structure of the medical safety net program established in 1965 for low-income children and children with disabilities.

The Senate bill, dubbed the “Better Care Reconciliation Act of 2017” would also repeal Obamacare taxes, restructure subsidies to insurance customers and cap Medicaid spending. While we could scrutinize the impact of any of these changes on rural Coloradans, the threat to children stands out as the most pressing issue of the health-care reform debate.

Expanding Medicaid eligibility to more adults helped reduce the number of uninsured Coloradans. Children weren’t the primary beneficiaries of the expansion, but they would be major victims of the repeal if efforts aren’t made to shield them from changes that would apply to adults. Structural cuts to Medicaid in either version of the bill would threaten access to care for children.

Deviating from our historical commitment to children cannot be part of any “solution” to make care more accessible and affordable.

Half of Medicaid’s 60 million enrollees are children, but they only account for 20 percent of the program’s spending. If lawmakers are focused on saving dollars, the last place they should focus is the child population — where early intervention and preventative care can positively impact long-term health outcomes to the benefit of taxpayers.

Children don’t choose to make healthy or unhealthy decisions or seek medical interventions to head off problems that could affect their ability to become productive members of society.

They don’t choose parents and must be held harmless when their parents can’t provide adequate health care through their own means.

Children cannot be collateral damage from the adult-focused debate about Medicaid. Thankfully, a large bipartisan group of Colorado health-care providers, child advocates, elected officials and business leaders — spearheaded by Children’s Hospital Colorado — has succeeded in persuading Colorado’s U.S. Sen. Cory Gardner to look out for children and see that they aren’t victimized in the process of overhauling Medicaid.

The group has made three recommendations to Gardner:

■ Grow Medicaid’s base-year spending on children by an amount equal to the medical category of the Consumer Price Index plus 1 percent.

■ Exclude disabled children and “medically complex” children from per-capita Medicaid caps.

■ Make sure dollars intended for children don’t get re-allocated to other populations.

Gardner, of one of 13 Republicans on a panel to repeal and replace Obamacare, should make it clear that his support for any version of health-care reform must include these safeguards for children.

Better still, Congress should make carve-outs for children more emphatic by reclassifying and renaming a safety net program exclusively for them. Call it MiniCare or Medicaid for Children or a national Children’s Health Insurance Program — whatever — but make it a silo that can’t be dragged into future policy debates about social entitlements.


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