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Some of the cruelest cuts that Republicans' Trumpcare would make are to children. The threat to children in rural areas has been documented, and now researchers are looking beyond to children with complex conditions like cystic fibrosis, autism, and Down syndrome. Or, in this case, hemophilia.
Mike and his brother have hemophilia, a rare disorder that prevents blood from clotting and is a literal threat to life and limb. He requires intravenous infusions of an expensive drug at least every other day to prevent bleeding. Despite great care, Mike had a severe complication when he was younger: a stroke after a normal toddler fall. You might not notice sitting in a room with him now, but his recovery is the result of years of intensive physical and occupational therapy.
About 37 million children—including Mike—are covered by Medicaid, comprising nearly half of all Medicaid enrollees. Mike is a good example of the challenges of caring for children with “medical complexity”— a group with the most complicated and costly health conditions for children. Children with medical complexity make up a small share of children but account for a disproportionate amount of care and spending due to their needs. In one study, children with medical complexity made up 6 percent of children enrolled in Medicaid in 12 states, but they accounted for 34 percent of all health spending for children in these programs.
The Senate bill would limit federal funding to state Medicaid programs on a per capita basis. Children who are enrolled in Medicaid based on being blind or disabled are exempted from this funding change, but other children in Medicaid would still be included in these caps. The cap for children will be set based on the average costs for the group over a baseline period and will increase yearly at a rate that is not directly connected to the needs of the population. State Medicaid programs will not receive any additional funding if the population costs more than the capped amount.
Daily Kos readers have made over 30,000 constituent calls to Senate Republicans in the last month opposing Trumpcare. If you live in a state with a Senate Republican, you can call, too! Call your senator at (202) 224-3121, tell them NO WAY to taking health insurance away from millions. Then, tell us how it went.
Health experts estimate that of the 5 to 6 million children like Mike, who have special needs and are enrolled in Medicaid, just 1.2 million would meet the Senate bill's "blind or disabled" definition based on the strict criteria for federal Supplemental Security Income (SSI) eligibility. Those other 4 million or so children don't meet that definition, and are on Medicaid because their family qualifies with a low-enough income. Come 2021, these very ill children would count the same as all the children on Medicaid when it came to the federal government sending money to states—meaning states won't get enough to cover their complex conditions along with the basic health care of all the other children.
“The potential consequences could be devastating,” said Sara Bachman, another researcher at the Catalyst Center. “States on their own are quite variable on the ability to support the services kids need.” The federal participation in the Medicaid program is an essential underpinning.”
These are children who would end up institutionalized, unable to live with their families, attend school, or grow up and live up to their full potential. All that traded for some big tax cuts to the already filthy rich.