While lawmakers continue to waffle over a new spending package, Medicaid cuts included in the last spending package passed by Congress – the One Big, Beautiful bill – are poised to put children’s health at risk, according to multiple experts.
“Children aren’t mentioned explicitly in the bill, but the authors say that many parents who lose coverage likely won’t realize that their kids can retain theirs,” said Weil Cornell Medicine of a perspective by researchers and clinicians from Weill Cornell Medicine, NewYork-Presbyterian and Ariadne Labs that was published Saturday in the New England Journal of Medicine.
They noted that 10 million people are expected to lose their health insurance by 2034, citing estimates from the Congressional Budget Office. As of last year, 8.2%, or 27.2 million, of Americans of all ages did not have health insurance, according to the National Center for Health Statistics. More than 40% of children in the U.S. rely on Medicaid for health insurance.
Dr. Beth McGinty, chief of the Division of Health Policy and Economics at Weill Cornell Medicine, co-founding director of the Cornell Health Policy Center and lead author on the perspective said that changes for adults are likely to “have big spillover impacts on kids.”
Along with potential confusion stemming from parents losing healthcare, the experts mentioned new limits the bill puts on the way hospitals recoup costs from treating uninsured children and children on Medicaid. This in turn increases concerns about funding for a field that “struggles financially because Medicaid reimburses children’s services at a lower rate than adult services,” Weil Cornell explained.
“Every day I face workforce challenges, trying to recruit enough physicians, enough nurses,” said Dr. Sallie Permar, chair of the Department of Pediatrics and the Nancy C. Paduano Professor in Pediatrics at Weill Cornell Medicine, and an author on the perspective.
This paper on the impending healthcare issues comes as concerns about the Supplemental Nutrition Assistance Program (SNAP) mount amid the ongoing government shutdown. According to the Johns Hopkins Bloomberg School of Health, this anti-hunger program serves more than one in eight Americans per month, and 39% of SNAP recipients were children as of 2023.
After SNAP benefits were suddenly cut, the Associated Press reported Saturday that “people across the country formed long lines for free meals and groceries at food pantries. However, New York Attorney General Letitia James announced Friday that “a federal judge ruled that the federal government must use its contingency funds to keep the Supplemental Nutrition Assistance Program (SNAP) running during the shutdown.”
Regarding the healthcare concerns, the authors of the recent perspective said there are things states can do to mitigate the impact on children.
For example, they can work to prevent kids from being erroneously unenrolled from Medicaid if their parents lose coverage.
“COVID provided a practice run for this,” said Weil Cornell. “During the pandemic, the Medicaid program dropped the requirement for recipients to prove they still qualified every year.”
Another thing states can do, according to the researchers, is investments in building up their pediatric workforce. Weil Cornell said many medical students, avoid pediatrics because it has relatively low salaries and that can “compromise their ability to pay off student loans.”
“Providing loan repayment for those who choose pediatrics could be one way to combat this trend,” said Permar. McGinty said that increased investment is important in the long-term, however.
According to the researchers, health systems can also help children by “taking care of kids holistically,” and “by making sure they have easy access to mental health and social services in addition to physical health services.” Holistic care can help reduce the risk of future health problems, Weil Cornell explained.
“We value children very highly as individuals and as a country,” Permar said. “But we’re not prioritizing them in our policy making.
And that needs to change.”