For nearly 50 years, Medicaid has served as a health care safety net for the poor, reducing the burden on families during periods of individual and national economic hardship. One in three children nationwide currently relies on health services provided through Medicaid.
Yet, in response to serious budget shortfalls and anticipated increased Medicaid spending in the near term, politicians from at least five states have threatened to withdraw from the Medicaid program, and nearly all state governments have taken or are currently considering steps to reduce their Medicaid costs.
While states are prevented from redefining eligibility standards to exclude currently eligible children, they may eliminate coverage for services not specifically required by federal Medicaid regulations, like prescription drugs, dental care or therapy services. Mississippi, for example, has already cut benefits for children with mental health conditions and disabilities like Down syndrome and cerebral palsy.
And in the last fiscal year, 37 states announced plans to reduce Medicaid reimbursement rates, which may result in fewer providers willing to accept Medicaid coverage. The immediate result would be that low-income children would face both greater difficulty accessing care -- and far more restrictions on the specific services that may be covered.
Millions of the nation's most vulnerable children currently depend on Medicaid and the Children's Health Insurance Program (CHIP) for a comprehensive set of health care services, including physician and hospital visits, screening and treatment, and vision and dental care. Reductions in Medicaid benefits and reimbursement rates have serious consequences for the health and well-being of American families.
The long-term human toll associated with shrinking or eliminating Medicaid is undeniable -- children in poor health are at significantly increased risk of chronic disease in adulthood, including diabetes, hypertension and cardiovascular disease. Uninsured, or underinsured, children often go without the immunizations they need. And they miss school at higher rates due to untreated illness. The fact is that timely access to preventive care in childhood saves money in the long run and provides greater assurances of a healthy and productive adulthood.
Pulling the plug on children's health care is not only morally indefensible, but it's also unwise from an economic standpoint. Without access to care, uninsured families would instead rely on emergencies rooms as their primary care facilities, sending hospital and state costs spiraling out of control.
There is no denying that fixing a massive budgetary and debt crisis will require significant sacrifices. But cuts in Medicaid and CHIP place an inordinate burden on poor children -- a burden that will inevitably result in a far less healthy and less productive future workforce. That is an outcome that will undermine both the nation's ability to sustain a long-term economic recovery and the capacity to innovate and grow in the decades to come.
Follow Irwin Redlener, M.D. on Twitter: www.twitter.com/IrwinRedlenerMD