Proposed Medicaid Cuts Risk Safety Net for Kids

Presidents of AAP and HAP Criticize Washington’s Failure to Account for "What Ifs"

As the House, Senate and the White House engage in debt ceiling negotiations, pediatricians and Pennsylvania health care agencies are speaking out against cuts to major entitlement programs, especially Medicaid.

While President Obama’s proposed cuts and tax increases are meant as a compromise and appeasement to the Republican caucus, just right of center, they will have negative consequences on the health care system and those insured by federal and/or state medical coverage.

These budget cuts could potentially affect 7 million children in the United States who are dependent on Medicaid and Children’s Health Insurance Plan (CHIP). What is most bothersome about the 2012 federal fiscal budget proposal is the switch to a block-grant system, which would provide a fixed budget regardless of demand and irrespective of eligibility of those that apply.

According to the PA Health Access Network, one in three children in Pennsylvania is enrolled in Medicaid and nearly half of all births in PA are paid for Medicaid. 

Essentially, this proposal would place an increased burden on CHIP to mend the holes in the public safety net, potentially compromising it at a time when those hit hardest by unemployment and the economic crisis need it the most.  This is not a problem that can be ignored; public health and safety should not be used as a bargaining chip against tax increases.

In a July 13 press release, Carolyn F. Scanlan, president and CEO of The Hospital & Healthsystem Association of Pennsylvania (HAP), said  “As part of the shared sacrifice to address growing health care costs and the federal deficit, Pennsylvania’s hospitals are already facing $9 billion in reductions and these cuts do not include additional cuts imposed by regulation and the 4.5% in Medicaid cuts just enacted in Pennsylvania’s 2011-2012 budget.”

A few more statistics from HAP about PA hospitals:

  • Care for 1.7 million inpatients and 38 million outpatients annually.
  • Evaluate 5.8 million injured and ill people per year in the E.R.
  • Deliver 133,000 babies per year.
  • Contribute nearly $100 billion annually to the state’s economy
  • Provide nearly 600,000 jobs.

Any cuts to Medicaid would push more responsibility on PA CHIP to cover expenses but, with $9 billion in reductions, how big will the holes in the safety net get?

The impact this will have on uninsured and underinsured children is a step backward for the state, returning to a time when even more families used emergency rooms as portals to healthcare or had limited access to providers. 

The populations most vulnerable to these cuts are children, pregnant women and infants. Without receiving preventative care, immunizations and early intervention, pediatricians are concerned that these cuts will negate all the gains made since is formation in 1992 and expansion in the 2007 PA CHIP campaign Cover all Kids, now insuring 190,000 children in PA.  

In the July 14 AAP president’s blog "Speaking of Kids," Dr. Marion Burton posted an entry entitled Medicaid Cuts Hurt Children; the post said “Let’s not go there.” 

With these budget cuts being based on the assumption that there will be no change to the number of children insured with parent-employer coverage, Burton raises concerns about the “what ifs?”  What if more people lose their jobs? What if more families lose their insurance or must switch to inferior coverage?  What if the block-grants proposed do not accommodate the increased need?  The “what ifs” are unconscionable.

Medicaid and CHIP, he says, assure a healthier workforce and adult populations in the future as well as reduce overall healthcare expenditures with preventative care and early intervention.   

“Why would anyone in a position of authority want to throw children under the uninsured bus?” said Burton.  

With our country in an economic tailspin, wondering whether it can cover its own debt, it is almost unfathomable that entitlements benefiting children and low-income families would be anywhere near the chopping block. Public health and safety should be the utmost importance to our leaders yet, this does not seem to be the case.  Instead of trying to benefit the greater good, Washington politicians have shown that they only care about getting reelected or catering to the wealthy who are not impacted by cuts in either Medicaid or CHIP.  

Medicaid is just one of the federal entitlements on the chopping block—Social Security, Food Stamps and WIC will also be negatively impacted by the proposed budget cuts and block grants.  Burton calls any such cuts that will devastate the already needy and steadily growing population of poor families in PA “unconscionable”

“We as a country must do better by our children,” says Burton, “the AAP will continue to hold policy makers and their proposals to a standard that all should embrace: do no harm to children.” This rallying cry on the AAP president’s blog holds no tone of optimism but may just be the prophetic warning of the “what ifs” that may come to pass when the safety net becomes as moth eaten as people’s pocket books.


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