Assaults on Medicaid: Threats to America’s most vulnerable children
Monday, September 10, 2018
Throughout America, the 2018 election may prove to be a momentous turning point for parents and supporters of vulnerable children, like children in poverty, children with chronic illnesses, and children with mild-to-profound disabilities. Not voting or voting for the wrong candidate may devastate these children.
Ongoing assaults on Medicaid help to explain why. They explain why every vote by Americans who care about these children should reflect their distrust of both the current executive branch of government and the current Congress.
Some readers may view this article as political propaganda. It’s not. Though it focuses on politics, it’s politics that’s willfully and visibly aimed at shattering Medicaid, causing great harm to the millions of vulnerable children (and adults) whose well-being and lives depend on it.
Fortunately, just about all the information needed to paint a clear picture of the potential catastrophe ahead is readily available from Pulitzer Prize-winning newspapers, Emmy-winning newscasts, and highly respectable organizations like the non-profit Kaiser Family Foundation (KFF) and the nonprofit Commonwealth Fund.
But why focus on one political party? Because registered voters, Green Card Holders, and other people concerned about America’s most vulnerable children (and adults) need to know which party and which politicians are doing what. In 2018, there’s no moral or functional equivalence on the issue.
The minority party is working to save Medicaid (and Obamacare), while the other is proudly working to destroy both. Without this information, voters may well skip the 2018 election or unwittingly vote for someone who will hurt their family.
A teen, excited about politics, may well volunteer to help a majority-party candidate whose vote to shatter Medicaid may cost his brother the spina bifida operation needed to correct his unsteady, dangerous gait.
In line with this, readers are encouraged to read the information I’ve linked throughout this article and follow the issues as described in venerable sources, like The Hill, which assiduously tracks congressional issues, actions, and elections.
Candidate Donald Trump promised that he would not touch Medicaid. Nevertheless, he’s started.
For America’s 36,862,057 children enrolled in Medicaid, what’s likely to surface is scary. President Trump, his party, and the Republican-controlled Congress have floated trial balloons to replace the current Medicaid funding system with block grants to states.
Sound innocent? It’s not.
If realized, block grants may well prove destructive, even deadly, to many children. History shows that block grants quickly cut inflation-adjusted federal funding to states, causing severe state-level budget cuts.
Slashing federal funding may force states to raise taxes or shred enrollees or cut benefits or cap enrollee spending or combine some of these. If, for example, New Jersey caps the number of eligible Medicaid recipients, it may deny Medicaid to formerly eligible children.
Thus John, on Obamacare’s Gold insurance, may recover in weeks, but Winslow, one of my former special education students in Newark, New Jersey, might suffer endlessly. Why? Capped Medicaid benefits.
Block grants may well force schools to cut Medicaid reimbursed services, such as occupational therapy, physical therapy, and speech and language therapy.
What will happen if a school, now strapped for money, denies these critical services to students like 10-year-old Deborah, one of my former special education students from Somerset County, New Jersey, who struggled to eat, walk, and speak?
My answer is not hyperbole, but the reality I’ve seen as a teacher, consultant, state hearing officer, and professor: Disaster. Searing problems. A lifetime of needless suffering.
Unfortunately, the threat of block grants has company. President Trump’s proposed budget for 2019 directly savages Medicaid and other programs critical to the health of many Medicaid enrollees, including children.
He calls for cuts of 22.5 percent to Medicaid, 27.4 percent to food stamps, and, 20.1 percent to Section 8 housing. Once this begins, it will quickly incinerate the social safety net, the only net that can save many families of vulnerable children.
Also scary is the proposed Republican congressional budget for 2019. Like the President's proposed budget for 2019, it aims to severely slash Medicaid. At the very least, a proposed congressional budget offered by the majority party signals the targets of their efforts.
In July, “House Republicans offered a budget proposal [for 2019] that would cut ... $1.5 trillion to Medicaid and other health programs .... New caps ... could lead to cuts in payments over time.”
If these cuts are enacted, can’t the Child Health Insurance Program (CHIP) address the needs of these vulnerable children? Unlikely.
CHIP’s resources are limited, its eligibility requirements are different, and it’s budget may well be slashed. As of 2017, CHIP supports almost 9,000,000 needy children while Medicaid supports 36,862,057 vulnerable children, including a vast number of children with disabilities.
Without a whopping increase in CHIP’s budget, which is unlikely, and a Congress willing to change CHIP’s mission, which is also unlikely, CHIP cannot overcome a shattered Medicaid program.
Alone, President Trump cannot incinerate Medicaid (or CHIP). He needs what he usually gets: Adherence of most Republican-controlled senators and congressional representatives.
Using feigned fear of the deficit, created by the Republican tax-cut law of 2017, congressional Republicans have started to argue for “entitlement reform.”
Already, the Republican-controlled House has passed a bill to cut food stamps. As a New York Times editorial asserted, the GOP wants “Hungry Kids to Fund Tax Cuts.”
Do What Can Work
Does this involve politics? Yes, as did the Fourteenth Amendment (equal protection of the law), Section 504 of the Rehabilitation Act of 1973 (Section 504), the Individuals with Disabilities Education Act (IDEA), and the Americans with Disabilities Act (ADA).
Without intense, focused, and sustained political action, these critical landmarks would never have seen the light of day.
Without them, what would happen to your child, to your students, to your neighbor’s family? If your child needed Medicaid and it was no longer available to her, what would you do? What could you do?
Clearly, if the House and Senate continue to be dominated by the Republican majority after the 2018 election, the parents and guardians of 36,862,057 vulnerable children will have to face these life-changing questions.
So, if President Trump and the Republican-controlled Congress’ destructive policies worry or upset you, what can you do?
Do what can work. In the November 2018 election, you can rein in President Trump and the Republicans’ destructive impulses toward our most vulnerable children by defeating the Republican Senate and House candidates.
To the extent you can, inform yourself about the issues, vote, and encourage similar-minded family, friends, and neighbors to register and vote. Actively support organizations dedicated to your values and concerns.
In sum, do what works, do what’s effective. Start now.
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