By Marsha Levick, Deputy Director/Chief Counsel, Juvenile Law Center; and Sue Mangold, Executive Director, Juvenile Law Center
Funding health care, including prevention and early intervention treatments for children, is crucially important for their healthy development. Providing access to health care for all vulnerable children and their families is also good social and fiscal policy. Last week, the U.S. House of Representatives passed the American Health Care Act (AHCA), a bill which, if it becomes law, will reduce access to health care for millions of Americans and will harm the most vulnerable children and families among us. As written, the bill will reduce Medicaid expansion as well as cut Medicaid funding through the use of block grants and per capita caps. Despite agreement about the importance of evidence-based policy decisions, this bill was rushed to a vote before its impact was even scored by CBO, or debated by our representatives.
Block granting and caps on health care as a method to fund and control costs will lead to the rationing of care and will stall any efforts to expand the health insurance safety net. Choices between care for seniors at the end of life will have to be weighed against health care for medically fragile children and mental health services for adults who care for them.
Under the provisions of this bill, children in the child welfare system, many with significant health care needs, will not always get the medically necessary treatment they require to reach their full potential. Children who have been abused and neglected will not be assured of the opportunity to heal, much less thrive with appropriate pediatric and mental health care. Block grants and caps will also harm the families of children in foster care struggling to get their children back and confronting challenges such as addiction and mental illness. The current bill will make it difficult for child welfare agencies to effectively serve and reunite families, increasing costs to child welfare agencies and risking greater harm to children’s development.
High quality health care accessible to every person ― especially the most vulnerable ― serves as a foundation for many of our essential social service systems. This health care bill will negatively impact them all ― child welfare, juvenile justice, special education, disability services, homelessness prevention, among others. This bill is a shocking example of legislation driven by political expediency with no consideration of the human costs, or data to guide the decision-making. It is also bad fiscal policy. We are committed to working with our many advocacy partners to ensure an informed debate in the Senate on the health care of our nation’s children and families so that future legislation reflects sound fiscal policy and provides affordable and accessible quality health care for all, including the most vulnerable among us.