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Senate Republicans are drafting their Trumpcare bill in secret, behind closed doors, so the exact outlines of what they're doing isn't entirely clear. But they've admitted that as much as 80 of the House bill will remain in their version, and we know what that means for vulnerable populations, particularly children. One estimate says that 4.7 million school-aged children could lose their coverage under Trumpcare. That's because of the $834 billion in Medicaid cuts, which the Senate might do more slowly than the House, but is definitely planning to include.
The Medicaid cuts in general have hospital and provider groups in a panic and they're sounding the alarm. But children's hospitals will be particularly hurt by the cuts, and they've been lobbying hard to tell Republican legislators just how much damage they'll be doing. Axios' Lazaro Gamio reports:
Roughly half of the money a children's hospital collects, on average, comes from Medicaid. More than 30 million kids are on Medicaid, and another 6 million are on the Children's Health Insurance Program. Mark Wietecha, CEO of the Children's Hospital Association, has been pounding those messages to legislators on behalf of the country's 220 children's hospitals.
Wietecha spoke with me about the Republican bill (teaser: he believes it has nothing to do with health care anymore) and why the Medicaid cuts deserve more attention. [...]
How would you describe the American Health Care Act's changes to Medicaid?
"It is a catastrophic bill for children's hospitals and really any hospital that's a high-Medicaid hospital. You take a category with 30 million kids — 40% of all the kids in the country — with an inadequately funded program, and then you reduce it. It just does not compute."
But Republicans have touted the budget savings from cutting Medicaid.
"They may save money on the budget, but it's the largest health care program for children in the nation. Right now, kids are sitting in the firing line with adults."
How do lawmakers respond to him when he points that out? "They just are generally unaware or haven't come to grips with the fact that the biggest cohort of affected people could well be children. When you say that to people, they just stare at you like, 'What? What are you talking about?'" That right there is a very good reason why this bill should have been dealt with through a normal legislative process, where Congress had hearings and groups like Wietecha's had a chance to testify and make clear what the consequences of the bill would be. But, of course, leadership doesn't want their members to have all that damning information before they vote. They just want to get the damned thing passed, no matter the consequences.
Which brings us to what Wietecha thinks this bill is all about: "It's now down to political survival and party existentialism." Which includes massive tax cuts to the wealthy.