A new report says the proposed Republican health care bill would shut out millions of disabled children who are currently covered by Medicaid under the Affordable Care Act.
According to Kaiser Health News, the GOP plan has such a narrow definition of "disabled" that only 1.2 million of 5-6 million children with special needs would be covered under Medicaid if the GOP bill passes the Senate.
The kids who would be covered by the Republican plan would have to be impoverished, and have to prove that they are blind or have "marked and severe functional limitations" that will last a year or are terminal.
Kaiser Health News notes that special needs children who do not meet the Republican's strict criteria are the same poor children who make up most of the disabled kids on Medicaid. The Republican plan would give the states the same amount of funding for those poor disabled kids that able-bodied poor kids would get, even though the poor disabled children have higher medical bills.
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This means cash-strapped states would have to either find the money to care for these disabled children, or reduce their services -- specialists, doctors, home health care, prescription medications, various types of therapy -- because of a lack of funds.
Janis Guerney, co-public policy director at Family Voices, which advocates on behalf of special needs children and their families, told Kaiser Health News: "It’s just a fraction of kids who we consider having special health needs who would qualify for the carve-out. The caps are going to put states under so much financial pressure that they are going to do away with the things they don’t have to cover."
Under the ACA, also known as Obamacare, middle-class families have been allowed to enroll in Medicaid, but they too would be placed on the chopping block of the GOP plan, just like low-income disabled kids.
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"Absent those supports paid for by Medicaid, the only option many families will have is institutionalization. You’ll see kids going into pediatric nursing homes, kids not being able to be discharged from hospitals," said Meg Comeau of the Boston University School of Public Health’s Catalyst Center.
Sara Bachman, who is also a researcher at the Catalyst Center, added: "The potential consequences could be devastating. States on their own are quite variable on the ability to support the services kids need. The federal participation in the Medicaid program is in an essential underpinning. States are really going to be in a pickle."
"We were trying to get as many of them, if not all of them, exempted from the cap," an unidentified Republican aide told Kaiser Health News. "But the problem is the only good definition and the only good numbers we had were for SSI."
The aide said the Republican Senate bill would force states to report on kids with special needs so the GOP-controlled Congress could later expand Medicaid funding to about where it is right now.
"Hopefully in a couple of years, when we have a better idea of who they are, we can get them in there," the aide added.
Until the possibility of funding comes through in a couple of years, the GOP bill would reportedly shut out about 400,000 seriously impaired children from families who are not poor, but face expensive health-related bills.
Medicaid currently allows these children to be covered while they live at home and a family member is paid via Medicaid to care for them. If the GOP plan goes through, those kids may end up in pediatric nursing homes or institutions.
Ben Long, from Kalispell, Montana, has a 13-year-old son who has seizures. He told Kaiser Health News the health care bills submitted to his private insurance company and Medicaid have reached over $2 million.
The Longs are one of the families that would be adversely affected by the GOP bill's cuts to Medicaid funding to states.
Long tweeted a link to the Kaiser Health News story that was reprinted in The Washington Post on July 10 and wrote: "4 million disabled kids kicked off #Medicaid & into pediatric nursing homes. [Senator Jon Tester] [Senator Steve Daines] VOTE NO."
Long also tweeted: "My son, and millions like him, deserve to live at home, not hospitals. #HealthcareBill has different plans."