Iowans, regardless of background or political affiliation, want children to receive the medical care they need to reach their full potential. That is a value shared by nearly all Americans. Just a few years ago former Gov. Terry Branstad led a bipartisan effort to expand Medicaid and fill one of the last gaps in our children’s health coverage. Today almost every Iowa child has access to basic health insurance. That is a true Iowa family value. The same commitment Americans make to covering seniors through Medicare should apply to healthcare coverage for children. Just as we honor and care for our parents and grandparents who built and protected this country, we should equally honor and care for our families whose children will build and protect our country’s future.
However, that historic accomplishment by our state government is in serious danger. The Medicaid changes proposed in the American Health Care Act (AHCA) as passed by the U.S. House would seriously undermine that commitment to protect our children’s health. If the current legislation passes without significant changes to the Medicaid provisions, we risk the health of an entire generation.
There is a misconception that Medicaid only serves people with low incomes, but that is just part of the story. Medicaid is also a safety net for children with complex medical conditions who are also covered by their parent’s private health insurance. Typically, insurance plans do not provide all the comprehensive specialty care and support that is required for children with severe or chronic health care needs. For example, almost every child diagnosed with cancer who receives their care at Blank Children’s Hospital is covered by Medicaid as either their primary or secondary health care insurance. This allows parents to help pay for their child’s care without bankruptcy or sacrificing the entire family’s future.
The math is simple. The AHCA requires $834 billion in overall cuts to Medicaid — a long-standing program that includes medical care for more than 30 million children nationwide, including 300,000 children in Iowa. The U.S. House version proposes distributing these cuts to individual states by either a block grant or a per-capita cap method. Either will predictably cause drastic Medicaid funding deficits at the state level, and then Iowa’s elected leaders will be forced to make tragically bad and short-sighted decisions. The decisions will be bad because not only will health services for Medicaid members be severely reduced or eliminated, but because health resources will be affected for all Iowans. Rural health services will be first to begin to falter followed by curtailment of comprehensive services in our major urban health centers. The decisions will be short-sighted because we will all eventually pay more than full price for our medical neglect. The guaranteed result is our children will suffer, our families will struggle and taxpayers will still get the entire bill — only down the road with interest and penalties added.
Many Americans have valid concerns that the last major federal changes to health care were rushed, partisan and resulted in many unintended consequences. Let us resolve not to make the same mistakes on an even larger scale this time. Soon the U.S. Senate will release their version of the AHCA. Iowans and our elected representatives deserve to have the opportunity and time to thoughtfully review, debate and provide feedback on any proposed healthcare legislation. That is the democratic process that made America great. Let’s work on health care together in that spirit.
Stephen Stephenson, M.D., is the president/COO of Blank Children’s & Women’s Services and executive vice president, UnityPoint Health-Des Moines.