American Health Care Act Could Jeopardize High Needs Children, Families Living in Poverty

After struggling to try to have a baby and coping with the disappointment of a miscarriage, military veteran Samuel Hibben and his wife, Jessica, welcomed their son on Valentine’s Day in 2016. Rafe’s arrival felt close to a miracle, but his young life did not get off to the easiest start.

Born with Cortical Visual Impairment — a kind of legal blindness — and significant developmental delays, Rafe faced challenges almost too great to overcome. Thanks to health coverage through the military’s health insurance program, TRICARE, and Medicaid, as well as early intervention services, Rafe now gets the care he needs for now.

Unfortunately, this care is not a certainty. If Congress passes the American Health Care Act (AHCA) and overturns critical aspects of the Affordable Care Act (ACA), that support quality health care for young children, the Hibbens will be at risk for a lifetime of developmental and financial challenges unimaginable only a few months ago.

This is true for thousands of other vulnerable families who depend upon programs like Medicaid to receive the health care they need. Medicaid largely pays for the early intervention services that are critical for children, like Rafe, who have developmental delays that should be addressed well before they enter school.

Why? Because brains grow faster between birth and age 3 than at any later point in life. Studies show that a baby’s brain makes more than one million neural connections every second, laying the groundwork for all future learning and development.

When health and developmental problems are caught early — through well-baby checks and routine screenings — it sets up children for a healthier start. Thanks to a half-century of steady progress from Medicaid, the Children’s Health Insurance Program, and now the ACA, a record low of only 3.2 percent of young American children are uninsured.

The AHCA’s changes to Medicaid, however, would translate into dramatic funding cuts to states over time, forcing them to limit who they serve and how they serve them. These changes would hurt young children, who rely on crucial Medicaid services, such as those guaranteed by Medicaid’s Early and Periodic Screening, Diagnosis and Treatment provision.

Without these services, vulnerable babies – including the nearly six million young children living in or near poverty and the 200,000 children under age 3 who come into contact with the child welfare system each year – are at increased risk for lifelong challenges. These children have a greater incidence of developmental delays, and in many cases, Medicaid is the only safeguard they have.

Parents will also suffer. Medicaid expansion has enabled many parents to get care, including mental health and substance abuse treatments, making them healthier and better able to care for and nurture their children. With the AHCA, Congress also enables states to remove the guarantee that health plans cover essential health benefits that are foundational to the healthy development of babies, and the health of their families. That includes maternity, prenatal, pediatric and mental health care services.

So, what would the AHCA mean for Rafe Hibben? While TRICARE would continue to cover part of the cost of his care, the changes to Medicaid will threaten his access to the services and therapies that help him thrive and overcome his developmental challenges.

The ACA recognized that parents with coverage are healthier physically and mentally, better able to nurture their children and more likely to get them the preventive care they need. The AHCA would undercut the care thousands of working families like the Hibbens depend on to raise their children and provide them with a strong and healthy foundation from which to grow and thrive.

The House developed the AHCA without a hearing or debate. Thankfully, the Senate still has the chance to reverse course and pass a bill that does not turn its back on America’s hard-working families.

The Senate should stand with the majority of Americans, including doctors and health care providers, to work toward a policy that supports families like the Hibbens. Doing so would provide the foundation that Rafe and millions of babies across the country need to grow up healthy and ready to succeed.



Matthew Melmed
is executive director of ZERO TO THREE and chairs the board of Generations United. Find him at @MatthewMelmed and www.zerotothree.org, or see www.thinkbabies.org for more information.

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