The Senate’s “Better” Care Act is Worse for Kids. A Lot Worse.

There is not a single provision in the Senate bill that would make the lives of children in America any better. Not one.

Across our country, we have reached a point where 95 percent of children now have health insurance coverage. We have cut the uninsured rate for children by 68 percent since the Children’s Health Insurance Program (CHIP) was created 20 years ago. Therefore, if Congress does nothing else with current health legislation, it should at least guarantee that children are not left worse off.

Sadly, the Senate bill will take us backwards through the imposition of $1 trillion or more in draconian cuts to our nation’s health care system. The cruel irony of its name — the Better Care Reconciliation Act — attempts to hide the fact that the bill would strip coverage and consumer protections from millions of children and families.

The assault on Medicaid is an historic bait and switch scam. Nobody who promised to “repeal and replace” the Affordable Care Act said they would eviscerate Medicaid to the tune of more than $800 billion dollars. With more than 37 million children enrolled in Medicaid, compared to 1 million in Obamacare, this is a direct assault on children that nobody campaigned on, including the President.

In fact, the Senate bill’s Medicaid per capita cap would impose even deeper and more draconian cuts on children, people with disabilities, and senior citizens than the House bill — legislation that President Trump referred to as “mean.”

There is no way to shield our nation’s most vulnerable children from Medicaid cuts of this magnitude. In fact, contrary to the President’s promises to eliminate onerous regulations and not cut Medicaid, the bill slashes over $800 billion out of health coverage in Medicaid while, ironically and simultaneously, giving states additional Medicaid administrative dollars to impose new bureaucratic and red tape barriers for those trying to access health coverage and care.

The federal government’s role will also change and likely grow, as it will depart from being a partner to states to improve coverage, quality, and access to care for people to a more adversarial relationship through the imposition of 255 new per capita caps upon states for the purpose of slashing hundreds of billions of dollars out of Medicaid funding to them.

There are 32 pages in the bill about how the state will count, calculate, account for, report on, and be held accountable for the newly-imposed per capita limits. There is great irony by which the very senators who are critical of “government health care” would be creating new bureaucracy at both the federal and state level. In our analysis, it is clear that Medicaid per capita caps will:

  • Be administratively complicated — A new bureaucracy at the federal and state levels would be required to define population categories, assign beneficiaries to the different subgroups, and to oversee compliance.
  • Shift costs to states — To the degree that states provide care for children and other Medicaid-eligible people, once a cap is reached the entire cost burden of that care would fall on state governments.
  • Create incentives that would harm children — Since states’ reimbursements would no longer reflect the actual costs of care, per capita caps would encourage states to ration care by changing eligibility criteria, cutting reimbursement rates for providers, or adding new administrative barriers to continuous coverage for eligible people, particularly those with higher costs and special health care needs.

From a taxpayer’s point of view, the Senate bill is prioritizing the use of taxpayer dollars to have federal and state bureaucrats fight with each other every year over the accounting of five different and arbitrarily-imposed limits in every single state, rather than work together to ensure better health coverage to real Americans in need.

For cover, the “Better” Care draft bill attempts to include a few provisions to make the draconian bill appear less harmful to children and families. For example, the Senate bill exempts children from the Medicaid block grant option in the bill. However, the vast majority of children would still be put at greater risk due to the increased severity of cuts under the Senate’s Medicaid per capita cap.

In fact, under scrutiny, the Senate bill will do little to prevent the oncoming disaster that over $1 trillion in cuts to the health care system that both the House and Senate bills would unleash.

This is not Better Care. It’s Worse Care. Much, much worse.