The American Academy of Pediatrics, Children's Defense Fund, Children's Dental Health Project, Family Voices, First Focus Campaign for Children, March of Dimes and National Association of Pediatric Nurse Practitioners issue the following joint statement opposing the American Health Care Act's (AHCA) drastic changes to Medicaid and their detrimental impact on children and families:
"Our organizations represent children, pregnant women, families, children's health care providers and advocates across the country, and we speak with one voice today to urge the U.S. House of Representatives to keep Medicaid strong for children and vote 'no' on the AHCA. This bill ends the Medicaid program as we know it, jeopardizing coverage for the 72 million vulnerable Americans – primarily children, pregnant women, seniors and people with disabilities – who rely on Medicaid for their health care.
Children make up the single largest group of people who rely on Medicaid; nearly 36 million children receive Medicaid coverage, including children with special health care needs and those from low-income families. Medicaid also provides comprehensive prenatal care to pregnant women, allowing millions of pregnant women to have healthy pregnancies and helping millions of children get a healthy start. Unlike many private health insurance plans, Medicaid guarantees specific benefits designed especially for children. Medicaid's Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefits are the definitive standard of pediatric care, covering an array of services like developmental, dental, vision and hearing screenings, and allowing health problems to be diagnosed and treated appropriately and as early as possible. Simply put: Medicaid works. In fact, children in Medicaid are more likely to get check-ups, miss less school, graduate and enter the workforce than their uninsured peers.
Medicaid is able to provide affordable, comprehensive care for every child because of the strength of Medicaid's state-federal partnership. The program already provides flexibility to states and allows each state to meet the needs of its Medicaid population when a natural disaster, public health crisis like the current opioid epidemic, or economic recession increases the number of people enrolled and the cost of providing services.
The AHCA includes harmful proposals to restructure Medicaid, and the changes to AHCA unveiled on Monday evening go from bad to worse, allowing even more damaging changes to the program. In addition to the bill's initial proposal to fund Medicaid through per capita caps, the amendments would allow states to choose a block grant model, which would eviscerate existing protections afforded to children and pregnant women in the Medicaid program. Comprehensive EPSDT benefits would no longer be required for children, allowing states to ration limited dollars by drastically cutting back pediatric services.
Block grants and per capita caps have a singular purpose, to reduce federal funding to states. In a bill that is supposed to be improving care for Americans, block grants and per capita caps shift costs from the federal government to the states, putting pressure on states to come up with the resources to cover their Medicaid patients when federal funds run out and costs inevitably rise. These drastic changes would place politicians, rather than health care providers, in charge of health care for children, pregnant women and families. Whether a life-saving childhood vaccination, a wheelchair or a hearing aid, politicians should not be the ones determining who gets what coverage, which providers offer those services, and what families must pay.
The AHCA does not make coverage more affordable for families. In fact, it makes it harder for families to afford premiums in the individual market and phases out the option for states to expand Medicaid to cover more low-income adults, which has led to tremendous cost savings for states and better health outcomes for families across the country. Having healthy parents means children are healthier, too. Stopping Medicaid expansion, restructuring Medicaid financing, and opening the door to harsh new requirements for Medicaid enrollees, as the AHCA proposes, are not only bad for state budgets, they are harmful to child health.
The AHCA's provision allowing states to deny Medicaid coverage unless mothers and fathers are working is especially onerous. This provision would mean that a married mother of an infant could be required to return to work 60 days after giving birth in order to keep her Medicaid coverage. Maintaining health coverage for mothers after birth is essential for infants' healthy development. Among adults with Medicaid coverage, about 80% are in working families; this proposal is not only short-sighted and dangerous, it offers a solution to a problem that does not exist.
In short, our organizations are united in opposition to any threat to Medicaid that would jeopardize the gains we've made in children's coverage and dismantle a pillar program that millions of families rely on. More children are insured today than at any time in American history; the AHCA will reverse that progress. We urge Congress to oppose the AHCA and to instead pursue policies that prioritize children and keep Medicaid strong."
Earlier today, many of our organizations joined a letter with more than 400 organizations dedicated to improving the well-being of children from all 50 states and the District of Columbia to urge Congress to keep the unique needs of children and their parents front and center as they consider any changes to the nation's health care system.
About the American Academy of Pediatrics
The American Academy of Pediatrics is an organization of 66,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit www.aap.org and follow us on Twitter @AmerAcadPeds.
About the Children's Defense Fund
The Children's Defense Fund Leave No Child Behind® mission is to ensure every child a Healthy Start, a Head Start, a Fair Start, a Safe Start and a Moral Start in life and successful passage to adulthood with the help of caring families and communities.
About the Children's Dental Health Project
The Children's Dental Health Project (CDHP) is an independent nonprofit that creates and advances innovative policy solutions so that no child suffers from tooth decay. Based in Washington, D.C., CDHP is driven by the vision of all children achieving optimal oral health in order to reach their full potential. We use data measurement and analysis to advance models that incentivize oral health, not just payment for treating the symptoms of dental disease. CDHP seeks to lead the way toward a health care system that is truly inclusive of oral health, from payment to care delivery. Learn more about CDHP at www.cdhp.org.
About Family Voices
Family Voices is a national, nonprofit, family-led organization promoting quality health care for all children and youth, particularly those with special health care needs. Working with family leaders and professional partners at the local, state, regional, and national levels since 1992, Family Voices has brought a respected family perspective to improving health care programs and policies and ensuring that health care systems include, listen to, and honor the voices of families.
About the First Focus Campaign for Children
The First Focus Campaign for Children is a 501(c)(4) nonprofit organization affiliated with First Focus, a bipartisan children's advocacy organization. The Campaign for Children advocates directly for legislative change in Congress to ensure children and families are a priority in federal policy and budget decisions. Learn more at campaignforchildren.org and follow on Twitter at @Campaign4Kids.
About the March of Dimes
The March of Dimes is the leading nonprofit organization for pregnancy and baby health. For more than 75 years, moms and babies have benefited from March of Dimes research, education, vaccines, and breakthroughs.
For the latest resources and health information, visit our websites marchofdimes.org and nacersano.org. To participate in our annual signature fundraising event, visit marchforbabies.org. If you have been affected by prematurity or birth defects, visit our shareyourstory.org community to find comfort and support. For detailed national, state and local perinatal statistics, visit persistats.org. You can also find us on Facebook or follow us on Twitter.
About the National Association of Pediatric Nurse Practitioners:
The National Association of Pediatric Nurse Practitioners (NAPNAP) is the nation's only professional association for pediatric nurse practitioners (PNPs) and their fellow pediatric-focused advanced practice registered nurses (APRNs) who are dedicated to improving the quality of health care for infants, children, adolescents and young adults. Representing more than 8,500 healthcare practitioners with 19 special interest groups and 50 chapters, NAPNAP has been advocating for children's health since 1973 and was the first NP society in the U.S. Our mission is to empower pediatric-focused PNPs and their interprofessional partners to enhance child and family health through leadership, advocacy, professional practice, education and research. NAPNAP.org