How the American Health Care Act Could Destroy Kids in Foster Care — Among Other Things

If you support the current version of the AHCA that is making its way to the Senate, and you have ever told me that you admire the fact that my husband and I were foster parents, you are going to need to reconsider one of those stances. Because this bill will inversely impact foster children and the families that our system is trying to reunite.

If you think that the 217 Republicans who voted for this measure in the House yesterday ( in a grandstanding show of partisanship and Bud Light toasting Rose Garden photo ops) made the right call, but you also think that my kids are pretty great and adoption from the foster care system is pretty awesome — well, you’re going to need to reconsider one of those stances too. Because if you think those things are true, you can’t support measures that will take away vital health care resources that help adoptive parents address the myriad of physical and mental health issues that kids who have traumatic backgrounds face.

If you support this version of the AHCA that defunds Planned Parenthood because you’re “pro-life” but you also support this version of the AHCA that repeals Medicaid expansions and could cut federal funding by 25%, you’re going to need to reconsider that label. Because if these measures remain in the final bill, and it passes, you’ve supported a system that does not support the lives you so desperately wanted brought into the world. You have supported a bill that cuts into measures that could help their mothers with pre-natal care, which is crucial to lifelong health. You have supported a bill that cuts into measures that could provide healthcare, counseling, dependency treatment, and a host of other programs to ensure healthy an intact families. If you want babies born and then don’t want to be part of a social contract that helps them thrive and live happy and healthy lives, you are not pro-life. You are pro-birth, and the difference has never been more apparent.

If you support this administration’s vision of healthcare in America, if you aren’t bothered by the fact that the House passed this bill (mostly unread by those who voted, save for summaries distributed) as a big “EFF YOU, OBAMA, THIS IS OUR CRIB NOW” and not a real and practical plan for our country, if you think that sick and old people should pay more and rape doesn’t deserve protection from being labeled a pre-existing condition and that people who have survived catastrophic illnesses should be denied insurance, if you think that foster kids who age out of the system should be left high and dry — then please don’t ever tell me that you think our family is so wonderful. Because you’re supporting measures that undermines them and hundreds of thousands of children like them, while creating an even heavier burden on the system.

See, here’s the part of adopting from foster care that my pictures on Facebook and our casual conversations don’t show: it is full of kids who have suffered. They’ve been exposed to drugs and alcohol in utero and face harrowing withdrawal symptoms when they’re just hours old. They’ve suffered from the effects of abuse and neglect and bear the physical scars as well as the ones that never heal. They’ve suffered the effects of poverty and food insecurity that have left them with eating disorders, hoarding tendencies, rotting teeth, vitamin deficiencies, scabies and lice and skin conditions. Some have seen their mothers sell their bodies and been pimped out beside her or watched as she was beaten over and over again. They’ve watched their parents shoot up drugs and overdose and regard drug paraphernalia as being as common in their homes as a lamp or a throw pillow. They’ve been left with family friends and relatives for long periods of time and wondered if anyone was ever coming back for them. Even the “lucky” ones — the ones who don’t get abused, who have food to eat, who have some sort of structure — they experience horrific trauma. Being taken from the parents you know and love and placed with strangers is trauma. Period.

These kids — my kids — OUR kids — they are innocent. They are amazing. They are loved. And, yet, they are statistically more likely to be teen parents. They are statistically more likely to have chronic health problems and up to 80% of kids who are in foster care have significant behavioral and mental health issues. They have increased risks for substance abuse due to genetic disposition, environmental exposure, and physical exposure in utero. And guess what the GOP’s plan to replace ACA with the AHCA eliminates? Mandatory mental health coverage and addiction treatment. Each state will decide if they want to, and can afford to, offer mental health and addiction support services to people on Medicaid. Not only does that impact our kids, but also the families they come from. Want a surefire way to ensure MORE kids enter care? Take away the addiction and mental health coverage that was holding their families together.

This bill will decrease federal funding for Medicaid by 25%, and states will be forced to make up the shortfall. Here in Delaware, we are already facing a budget crisis. Cuts to education, state worker benefits, and other key areas are already in the works. With the loss of this funding, where does that leave us and other states like us? There will be a rationing of services; providers, assistance, and benefits to our kids who are in foster care or adopted from, will suffer. The ACA allowed for foster youth aging out of care to stay on Medicaid until they are 26, giving them a chance to maintain their health and pursue education without needing to find employment to receive healthcare. The AHCA removes that provision. Kids who are cut from care at 18, who have lost their parents and now lose their foster care benefits will be forced to make their way in the world — alone, broke, traumatized, and uninsured. It’s no wonder that a University of Chicago study shows us that only 6% of former foster youth obtain a college degree, and 34% are arrested before they’re out of their teens. It also tells us that support of foster youth past the age of 18 increases their likelihood to complete at least some college and decreases their chances of being arrested. But, by all means, let’s cut that 25% and hope for the best. I don’t know about you, but I’d rather my tax dollars go towards of increasing quality of life and decreasing crime than funding three presidential residences. At least funding Medicaid enhances the overall well-being of our society.

Children adopted from foster care in the state of Delaware are eligible for Medicaid until they reach adulthood. Some, who are deemed to have unique behavioral or medical needs are also eligible for an adoption stipend. Most have what could be considered “pre-existing conditions.” All three of mine do. Although we consider ourselves lucky that we can provide private insurance coverage for our children as well, not all families can do so. Some children have needs that far exceed the private coverage allowances — especially under the AHCA. Medicaid is a necessity for these children who need lifelong care in order to help ensure that they are not languishing in the system, but adopted into loving homes. We cannot rely on insurance companies to have a moral compass when it comes to compassionate and equitable care. We need those mandates.

I know that this bill has a long way to go. I know that the Senate will tear it apart and the version that passes — if it passes — will look very different. But I also know that some of you reading this took yesterday’s vote as a victory. Something inside of you swelled with happiness as you watched our president pump his fist into the air like he’d just accomplished something extraordinary. Let me tell you a little something about that victory celebration; it’s not about healthcare, it’s about revenge. It’s about pandering. It’s about dismantling a system that helped millions of Americans. Trump is looking for his magnum opus after months of reform failure, and he’s willing to get it at any cost. Sadly, it seems that over 200 Republican House members were willing to go along with the charade.

So, please: if you’ve ever met my kids or looked at my family and felt any kind of love towards them, or admiration for their perseverance, or even just curiosity about their situation — I’m asking you to side with morality and humanity. I’m asking you to speak out against the AHCA and to urge the Senate to vote No to the brutal and premature repeal and replacement of the ACA. I acknowledge that the current plan is not perfect. I can also acknowledge that many aspects of the administrative portion need to be worked out. But we cannot lose Medicaid funding — not even a portion of it. We cannot defund women’s healthcare. We cannot make it optional to over mental health and addiction funding, especially to those in critical socioeconomic situations. Without those crucial stipulations, we are not only creating an inequitable system for our foster care youth, but we are also increasing the burden on an already over-burdened system.

After all, when the American Medical Association, the American Psychological Association, the American Cancer Society, and the American Academy of Pediatrics are all against the new reforms — and Congress itself exempts itself from the provisions — it’s clear that we are headed in the wrong direction. Don’t let this administration destroy the livelihood and well-being of children to save face. Speak out. The life of someone you love may depend on it.