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Cuts to Medicaid will be felt most by children

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Any cuts to Medicaid, the Children’s Health Insurance Program and the Affordable Care Act will extract a cascading toll on the status and stability of our lives. (Dreamstime/Tribune News Service)

Despite the failure of Republican efforts to repeal and replace the Affordable Care Act, the battle over health care is not quite over. If the majority in Congress are intent on jeopardizing health care for millions of Americans by undermining the ACA, there are still numerous opportunities to do so.

The federal government is on a continuing resolution that expires on Sept. 30, and if there is not a new continuing resolution or a new budget passed, we could witness a government shutdown.

According to Anthony Wright, executive director of Health Access, the budget the Trump administration is considering includes cuts to health care programs on top of the cuts that they were seeking through the ACA repeal. “Any tax cuts that are presented will potentially need a funding source and cutting Medicaid could be the way that they fund tax cuts,” Wright stated.
Let’s be clear: All people are affected by limitations put on health care coverage, but especially children, and particularly children of color.

Two out of five Californians with Medicaid are children, reported the California Budget and Policy Center in June 2017. Children make up the single largest group of Medicaid beneficiaries. There’s no way to cut the program without harming kids, parents of kids and the providers that serve them, including children’s hospitals.

“Today, the rate of children’s coverage in California is at a historic all-time high of 97 percent, reflecting the fact that these programs: Medicaid, Children’s Health Insurance Program and the Affordable Care Act are working for kids and families,” said Mayra E. Alvarez, president of The Children’s Partnership.

Take asthma, for example. According to a 2015 California Health Interview Survey, in San Francisco county, 18 percent of children ages 1-17, have been diagnosed with asthma. For these kids to function effectively in school, they will need access to timely treatment.

Indeed, studies show that kids who have their health needs met are better academic performers and less likely to drop out of high school. According to Alvarez, children covered under Medicaid are more likely to graduate from college and grow up to becoming healthy, productive individuals with more earning potential and hence less reliant on safety net programs.

“Children don’t vote but they are 25 percent of our population and every bit of our country’s future,” said Alvarez.

Together, Medicaid, the Children’s Health Insurance Program and the ACA cover 5.7 million children in California, according to Alvarez. Roughly three out of four children enrolled in Medi-Cal (California’s Medicaid program) in California are from communities of color. In San Francisco county, 23 percent (52,628) of all Medi-Cal enrollees (225,570) are under 17 years of age with a good 72 percent of this group being children of color.

Half of all kids in California are part of an immigrant family. Many families are of mixed status — where one or more members are undocumented — and about 1.5 million children have at least one undocumented parent.

Last year, California took steps to expand coverage to all children regardless of immigration status. To date, Medi-Cal/CHIP has covered 189,000 undocumented children with state funds. “This year we got legislative interest on the idea of extending the Medicaid program to cover all young adults, regardless of immigration status,” said Wright, though ultimately it was not included in the state budget.

One of the questions frequently raised in discussion forums these days is about the anti-immigration rhetoric and its impact on health care services. Would health care enrollment information be shared with U.S. Immigration and Customs Enforcement? Many families in The City worry about the threat of deportation and have even considered pulling their kids out of health care programs or simply not enrolling their kids for fear that names and details would be made available to ICE.

“The policy and the precedent and the practice has been that all this information is private and can only be used for health care purposes. And while we don’t know what will happen in the future, right now that is the policy and folks should get the coverage that they need,” Wright said.

The health of our children is paramount to the health of San Francisco. We must make sure that our elected representatives make every attempt to protect both Medicaid and CHIP so parents have peace of mind, and children under our protection have access to health care and have the opportunity to grow up without being hobbled by poorly thought through cuts on essential services. The stability of our economy hinges on that.

Any cuts to Medicaid, the Children’s Health Insurance Program and the Affordable Care Act will extract a cascading toll on the status and stability of our lives.

As Alvarez puts it, “Our health is fundamental to our opportunities, and the healthier we are, the more freedom we have to pursue our dreams and contribute to our families, to our workplaces, our communities.”

Jaya Padmanabhan can be reached at jaya.padmanabhan@gmail.com. Twitter: @jayapadmanabhan. In Brown Type covers immigrant issues in San Francisco.

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