When my daughter was younger, one of her favorite activities was building tall towers with a set of colorful wooden blocks. With a determined look on her face, she would start with the largest blocks and concentrate on getting each new block to balance carefully, building a sturdy foundation for the ever-growing tower.
Raising kids is a lot like building a tall tower of blocks. We need to build a strong foundation so that additional skills and responsibilities can be added on top of that sturdy base as they grow. One of the most critical foundational blocks needed to raise successful kids is access to quality health care.
For more than 50 years, our country has shared this value. At both the federal and state levels, we have enacted policies that have resulted in 95 percent of children in Virginia now having health insurance. Just as my daughter was rightfully proud of the tall towers she built as a toddler, we should take pride in this remarkable achievement for our children.
Unfortunately, the Affordable Health Care Act, currently being rushed through Congress, threatens to knock down that tower and destroy what has taken more than 50 years to build.
The largest threat to children's health in the new proposal is that it dismantles the Medicaid program, a primary source of health insurance coverage for children. In Virginia, more than 488,000 children and more than 15,000 pregnant women are covered by Medicaid. One in three births are covered by Medicaid. Roughly 30 percent of children with disabilities or special health care needs are insured through Medicaid, as are all children in foster care.
The effectiveness of Medicaid coverage for children lies in its design: guaranteed coverage that provides economic stability for families, pediatrician-recommended services (including dental care, developmental screenings and mental health care), and cost-sharing protections for families.
As Dr. Richard Bennett, a local pediatrician, explains, "Medicaid allows the pediatrician to serve as the quarterback. I handle routine visits and conditions like asthma and ADHD, and I can refer children to specialists for conditions such as diabetes, scoliosis, sickle cell disease, or more intensive mental health disorders because Medicaid covers them."
Furthermore, services covered by Medicaid are provided not only in doctors' offices and hospitals, but also in homes, schools, and other community settings that support the overall healthy development of the commonwealth's children.
Since Medicaid has been around for so long, we have research demonstrating its return on investment. Children enrolled in Medicaid miss fewer days of school due to illness or injury, perform better in school, and are more likely to graduate from high school and attend college than their peers with similar backgrounds but without insurance. As adults, they are healthier, earn higher wages and pay more in taxes.
Currently, Medicaid expenses are shared by the state and federal government; in Virginia it's a 50-50 split. The new congressional proposal would fundamentally change the program by creating a "per capita cap" - a set amount of funding per Medicaid enrollee that would significantly decrease the federal share of spending on the program. The Congressional Budget Office released figures showing the bill cuts $880 billion from federal Medicaid costs over 10 years - essentially an $880 billion cost-shift to the states.
It is unreasonable to think that Virginia would be able to absorb its share of that kind of a hit to the state budget, and that's where the carefully built tower of children's health insurance comes crashing down. Virginia's policymakers would be forced to make drastic cuts to the state's Medicaid program to balance the budget. Children make up half of all Virginia Medicaid enrollees, and they would no doubt be hurt by reductions in eligibility, benefits, or provider reimbursements that would cause doctors to stop seeing kids with Medicaid.
It is important to point out that children would not be the only losers if this bill passes. Virginia's lawmakers would be forced to ration care among the state's most vulnerable populations: children and adults with disabilities, low-income seniors in nursing homes, low-income pregnant women and children, and adults struggling with serious mental illness and addiction.
Fortunately, several Virginia state policymakers from both sides of the aisle have publicly spoken out about the harm that would come from reducing the federal investment in Medicaid. We hope their counterparts in Washington will listen. Collectively, we have worked too hard over the past 50 years building a strong foundation for Virginia's children to have Congress obliterate it now.
Margaret Nimmo Holland is executive director, Voices for Virginia's Children. Contact her at firstname.lastname@example.org.