The American Health Care Act proposed by Congress that would restructure Medicaid as a per capita cap program would sever the historical federal-state partnership of program funding, creating barriers for the 1.2 million children in Pennsylvania who rely on Medicaid for health care coverage and put the state's fiscal viability in deeper peril than it already is. The state's budget deficit is currently $3 billion.
"Capping funding for Medicaid will cap coverage when health care costs rise or a child has greater than average health care needs," said Pennsylvania Partnerships for Children President and CEO Joan Benso.
"For example, a child who is in a car accident, faces a multiple-day inpatient stay, surgery and extended physical therapy would likely exceed the cap. The same would likely be the case for children who have chronic diseases such asthma. In these instances, the state or the child's parents would have to cover those costs. Kids should get the benefits kids need, no matter what," she said.
Specifically, the American Health Care Act would:
Benso noted that changing the funding structure of Medicaid breaks the handshake between the federal government and the state to fund the program at a time when Pennsylvania has reached an all-time low of only 4.1 percent for the number of kids lacking health insurance.
"Restructuring Medicaid as a per capita cap program is being promoted as giving the state more 'flexibility' or 'control.' The state already has control over these programs, and for 50 years has operated health care programs in a way that works best for our child population," she said.
If Medicaid is changed to a per capita cap funded program, federal funding would be based upon a set amount for each enrollee. The proposed language creates eligibility categories including children, blind and disabled, seniors, Medicaid expansion enrollees and other adults. Pennsylvania's historical costs in the Medicaid program, subject to a potentially inadequate inflationary factor, would serve as the base amount of federal funds received.
"The U.S. House of Representatives is moving this bill ahead in the coming days without hearings or more careful consideration on how it will negatively impact our citizens in greatest need. These changes will not be in the best interest of the commonwealth or our children. We urge our members of Congress to reject the proposal," said Benso.
Pennsylvania Partnerships for Children is a strong, effective and trusted voice to improve the health, education and well-being of children and youth in the commonwealth. For 25 years, PPC's public policy victories have helped countless children learn, thrive and succeed, regardless of circumstances. PPC is statewide, independent, non-partisan and non-profit.