We've been hearing a lot about winners and losers these days. Yet, even as our kids on the baseball or soccer fields may be winning trophies, they are in imminent danger of losing something much more important.
Children in Oregon and across the country risk losing health care coverage through Medicaid, and the benefits that accompany it, due to the Senate's Better Care Reconciliation Act (BCRA).
The BCRA provides tens of thousands of dollars in tax breaks to the top 1 percent richest Americans, raising their incomes by 2 percent. It cuts financial aid that families need to obtain coverage. It cuts the average federal contribution over the next seven years to 57 percent of the actual cost of Medicaid, leaving states to pick up the tab or cut eligibility and coverage. It allows radical cuts to which health services can be covered. In short, these drastic cuts to Medicaid and health services, huge financial benefits to the wealthy, and cost-shifts to states, will result in millions of Americans, millions of children, losing coverage.
Here are five ways children could lose in the BCRA:
• First, attacking Medicaid expansion puts at risk health coverage for the more than 30 million children across the country who depend on it; children account for 43 percent of all Medicaid enrollees. In Oregon, more than 400,000 children receive their health care coverage through Medicaid and "CHIP," the Children's Health Insurance Program Gains made since 2008 in children's health care coverage will be lost even though expanded eligibility and coverage has led to more children receiving the health care they so desperately need.
• Second, rural children will be disproportionately affected by cuts to Medicaid because poverty rates are higher in rural Oregon. The agriculture and small business jobs in these communities are less likely to offer insurance through employment. In fact, more than 9,000 children in Eastern Oregon's Second Congressional District rely on Medicaid and CHIP for their coverage, which protects their families from financial risk. Children in both urban and rural areas thrive when they have primary and preventive care.
• Third, children with pre-existing conditions will suffer. Although companies can't charge sick children more for their coverage, they can cut which health conditions they choose to cover. There will be no guarantee of mental health, dental, drug and addiction services, or even maternity care. The Congressional Budget Office estimates that maternity and mental health coverage will be dropped from many policies in many states, making them much more expensive for those who need them. The lack of accessibility of these services would disproportionally harm those least able to afford them.
• Fourth, kids with severe disabilities will have fewer choices and less access to care when Medicaid is capped. According to the Kaiser Family Foundation, nearly half of all children with special health needs receive health insurance through Medicaid, CHIP, or public coverage. Low-income families with disabled children rely on early screening, diagnosis, and treatment. The BCRA slashes funding to pediatricians and children's hospitals providing those services.
• Fifth, caps to Medicaid are a calamitous cost-shift to Oregon, which is already financially over-burdened. Make no mistake: caps are cuts. According to the Congressional Budget Office, the "caps" amount to $772 billion in cuts. The BCRA passes the buck to states and risks damaging kids — now and into the future. More than 50 years of data prove that kids with Medicaid coverage have better health, fewer adolescent deaths, lower high school drop-out rates, higher college graduation rates, and greater wealth and income. Eviscerating Medicaid will never bring Oregon the results children deserve.
Don't be fooled by the promises of legislators who want a "win" with this plan. In the end, when Senate Republicans cap Medicaid and end essential benefits, and leave the most vulnerable Americans to pick up the tab, Oregon's kids lose.
U.S. Sen. Jeff Merkley is a Democrat who serves on the Senate's Appropriations and Budget committees. Tonia Hunt is executive director of Children First for Oregon.