What's More Important: A Campaign Promise Or The Health Of Millions Of Children?

Whenever I hear supporters of the Graham-Cassidy bill talk about why it should be passed, the main reason seems to be that Republicans need to fulfill the campaign promise of getting rid of Obamacare.

So fulfilling a campaign promise is more important than the health of millions of children? Because let’s be clear: the Graham-Cassidy bill is bad for the health of children.

Medicaid gives health coverage to 37 million American children. Without Medicaid, their families would not be able to afford the health care they need when they were sick, or the health care that helps prevent them from getting sick in the first place. Any change in Medicaid that leads to caps, or limits expansion, affects those children.

Speaking of expansion, the Medicaid expansion that was part of the Affordable Care Act (or ACA, otherwise known as Obamacare), provided health care coverage to millions of low-income adults, many of whom are parents. The Graham-Cassidy bill would eliminate that expansion. That would mean that those parents would either not be able to afford the health care they need, which affects their children, or be saddled with huge bills—which affects their children too.

The ACA built in protections so that people with pre-existing health conditions, and elderly people, couldn’t be charged more for their health care. The Graham-Cassidy bill does not have those protections. Supporters say that everyone would have access to insurance, including the elderly and people with pre-existing conditions, but there is a big difference between availability and actual access. If health insurance premiums cost so much that you can’t afford them, then you don’t have access to health insurance. As many as 1 in 4 children in the US have a chronic health condition. Do we really want to put the health of 1 in 4 children in jeopardy?

It has to be a red flag that no medical professional society is in favor of this bill. In fact, six medical groups (the American Academy of Pediatrics, the American Academy of Family Physicians, the American College of Physicians, the American Congress of Obstetricians and Gynecologists, the American Osteopathic Association and the American Psychiatric Association) sent a joint letter to Senators McConnell and Schumer opposing Graham-Cassidy, saying that this revised proposal may be worse than the original.

Nobody’s saying that the ACA is perfect, or that there aren’t problems with our health care system. We absolutely need to work together to make health care more accessible and affordable. But as we say in medicine, primum non nocere: first do no harm. Graham-Cassidy would do harm—including harm to children, who rely on us to care for them.

We’ve all made promises that we regret, or that we shouldn’t have made in the first place. Sometimes we make them without really thinking it through, sometimes circumstances change. It takes wisdom and humility to know and admit when promises need to be broken—and new ones made.

I really hope that our legislators have the wisdom and humility to understand that campaign promises can’t be more important than the health of children—and that our children deserve better promises.