By Dianne Feinstein
Originally appeared in the Los Angeles Daily News
Providing quality health care to our nation’s children should be sacrosanct. But for many members of Congress, it’s not. The Senate Republican health care bill has made that clear.
The bill’s draconian cuts to Medicaid — used to pay for tax cuts for the richest Americans — would potentially devastate care for California’s children, particularly those with disabilities and complex health care needs.
During a visit last week at UC San Francisco Benioff Children’s Hospital, I met three heroic mothers of children with extraordinary health care needs: one with cerebral palsy, one with a congenital heart defect and one with VATER syndrome, a set of rare birth defects.
Even though these families are middle class and covered by private insurance, they still can’t afford the care their children require. Medicaid, however, fills in the gaps. It covers in-home nurses and medical equipment, services that private insurance doesn’t cover.
Without this help, these three children — Maggie, Megan and Drew — would have been forced to spend long durations in institutions to receive the care they need, not only forcing them from their homes but also costing much more.
If the Republican Senate bill passes, many more children may be forced out of their homes into institutions, a stunning indictment of a party that professes its commitment to “family values.”
Let me explain how: The Senate bill, like the House bill, goes far beyond repealing the Affordable Care Act. It essentially ends Medicaid as we’ve known it since it was created in 1965.
Today, Medicaid covers half of all children in California — 5 million total. The program has always been a partnership between the states and the federal government. The federal government has paid a fixed share of all health care costs for Medicaid beneficiaries. Under the Republican plan, that partnership would end.
The bill would place strict limits on federal payments, and states would be on the hook for all costs above those limits.
The Medicaid cuts in the Senate bill are $772 billion over the first 10 years, with even more drastic cuts down the road. California would be required to pay $30 billion more per year by 2027 and $115 billion more per year by 2037. Over the next 20 years that would lead to a 35 percent cut to the program.
These cuts would be backbreaking for California’s finances, forcing extremely difficult choices. If the state couldn’t come up with the $30 billion needed to cover the gap by 2027, millions could lose their Medicaid insurance.
California’s Medicaid director has said that “Nothing is safe — no population, no services.”
This means that health care for children like Maggie, Megan and Drew could be on the chopping block.
One of the first areas these cuts would be felt are in our state’s children’s hospitals, where up to 80 percent of patients are covered by Medi-Cal. They would inevitably need to reduce services and consolidate locations where care is provided. Their very existence would be threatened.
One example is Children’s Hospital Los Angeles, one of the country’s top 10 children’s hospitals, where 72 percent of patients are covered by Medi-Cal. Dr. Paul Viviano said that the cuts in the Senate bill would threaten their programs and endanger lifesaving services.
These cuts wouldn’t only jeopardize Medicaid patients, though. That’s because the research and training of specialists at children’s hospitals improves care for children nationwide. If a specialist physician isn’t available — or is never trained in the first place — that hurts all patients.
These cuts also threaten the wide range of supplemental services like speech and physical therapy that allow children with disabilities to live full and productive lives. Many of the letters and calls I’ve received in opposition to the bill have been from mothers advocating on behalf of their children with disabilities. They know what these cuts would mean for their families.
Kristen, a constituent from Sacramento, has a daughter named Riley who has autism. Riley is reading above grade-level thanks to the comprehensive therapy she receives through Medicaid. Those programs would likely suffer under the Republican bill.
Beth from Davis has a son named Patrick with Down syndrome who also battled leukemia as a child. Patrick will soon graduate from high school. Beth expects him to secure a job and live independently because of the support he receives through California’s regional center programs.
Medicaid provides the vast majority of the $2.5 billion in federal funding that our 21 regional center programs receive to facilitate job-training, physical therapy and other supports for those with disabilities.
The wealthiest country in the history of the world shouldn’t be forced to choose between providing adequate health care for children with autism or Down syndrome, or between closing care locations and running a graduate medical education program to train future pediatric subspecialists.
If Senate Democrats are unable to defeat this plan and Republicans pass it, our country would effectively abandon families during the most painful and difficult times in their lives, telling them that they’re on their own. That’s not the type of country we are, and it’s up to Senate Republicans to prove it.
U.S. Sen. Dianne Feinstein is a Democrat representing California.