By Joanne Samuel Goldblum
CEO, National Diaper Bank Network
The Republicans on the House Energy and Commerce Committee (E&C) are proposing structural changes to Medicaid, as a cost-cutting measure, within the tax reconciliation bill. The nonpartisan Congressional Budget Office’s preliminary estimate is that at least 8.6 million people would lose health insurance, as a result of these changes. Medicaid enrollees are primarily children and their parents. More than 40% of births in the United States are covered by Medicaid. This means that the proposal now in committee would cut off access to health care for millions of children and their mothers.
It is not okay to put mothers and babies at risk. Members of Congress surely must know that. Now is the time for all Americans to remind them. The National Diaper Bank Network (NDBN) has more than 240 member diaper banks across the United States, supported by good people – people of all political stripes – who believe that every baby has the right to be clean, dry, and healthy. This essay is not a foray into partisan politics. It is simply a review of the facts by someone who has spent her career trying to keep kids healthy.
A wealth of evidence shows that providing preventive care, like visits to pediatricians for check-ups, actually saves money. Furthermore, there are studies demonstrating increased educational attainment for children enrolled in Medicaid and decreased disability in adulthood. Absent good primary care, children will come into emergency rooms with serious illnesses that might have been averted. This will stretch the financial and clinical resources of hospitals, many of which are struggling already. These cuts would result in growing medical debt, as families will be required to cover new and larger copays for medical care. More hospital closures may occur, impaling an already fragile maternal and child health care system, especially in rural areas of our country. To be clear: this will put anyone birthing or being born in these communities at risk – regardless of who pays for their health care.
Proposed cuts would eliminate insurance coverage for post-partum mothers, services that have been repeatedly shown to result in decreases in maternal and infant mortality. The changes being discussed would make it harder for eligible infants and children to enroll in Medicaid, penalize states that provide Medicaid coverage for undocumented children, add new copayments for preventative healthcare services such as prenatal care and well child pediatric visits, and allow providers to deny services if a parent or child on Medicaid cannot pay their copay.
A $35 co-pay is, tragically, enough to keep children from getting critical services such as developmental screenings and hearing and vision testing. NDBN’s research shows that one in two young families struggles to afford the diapers they need to keep their children clean. Families list many items they cut back on – including food and medical visits – to keep babies diapered. Think of families with multiple children – or one toddler who picks up every ear infection going through their child care center? Parents will be faced with impossible choices.
The measures E&C is considering to change Medicaid seem outrageous. Perhaps they are meant to be just that – so shocking that people who care about women and children’s health will be too disheartened to organize and respond. But the advocacy community I know is determined, focused, and most importantly in this case – quick on its feet.
This is not a done deal. It’s a horrible idea that can be stopped if well-informed people tell their representatives right now that we did not send them to Washington to endanger mothers and babies.
