Block Grants for Medicaid – A Very Bad Idea for Kids
There is a lot of talk these days of ending “entitlements” as a solution for our $14.3 trillion debt. When seniors heard about the threat to Medicare they showed up at Town Hall meetings and made their opinions loud and clear – “Keep you hands off our Medicare!” Now many Republicans who initially signed on and voted for Chairman Paul Ryan’s (R-WI) House budget – breaking up Medicare – are backing off that commitment.
That’s the power of having a voice and a vote – especially when your health insurance (maybe your very life) is at stake. But what about Medicaid? Who will confront the powers that be for a program that cares for the most vulnerable – including 30 million children?
During the current economic downturn, the critical role of Medicaid as part of the safety net has been very apparent. Widespread unemployment created a new population of children and families who met eligibility requirements for Medicaid. The enactment of health care reform will add even more children to the rolls.
Delivering Medicaid to states through block grants would mean huge cuts in enrollment and coverage.
Medicaid is counter-cyclical: when the economy contracts, more people become eligible for the program, conversely, when the economy expands and adds jobs, fewer people are eligible. As an open-ended entitlement program, anyone who is eligible for Medicaid is guaranteed coverage. However, the increased demand during economic downturn puts pressure on states, as Medicaid is a state/federal partnership.
Block granting the program limits program flexibility. Without federal help, states will be hard pressed, or completely unable, to afford expansion to meet the needs of families losing their jobs and health insurance during periods of economic weakness. For example, monthly enrollment of children in Medicaid increased by 16.4% nationwide between June 2008 and June 2010, reflecting an increase from 22.8 million to 26.5 million children enrolled. This expansion would not have been possible under state block grants.
The Ryan Budget approved by the House would also drop the mandate for states to provide the Early and Periodic Screening Diagnostic and Treatment (EPSDT) benefit. This federally required benefit, when administered, screens and detects health and developmental conditions early in childhood allowing for timely treatment. The EPSDT benefit ensures coverage of infants and young children for developmental assessments, well-child visits, vision, dental, and hearing services. Block-granting Medicaid will eliminate this mandate.
One in four children are eligible for Medicaid in this country. It is crucial to the health and well being of the children of this country to have access to doctors and services that will support their healthy development.
Who will speak up for the children who need Medicaid if not us? We have a voice and a vote. They don’t.
See Promise the Children Action Alerts
For more in-depth analysis:
The Children’s Health Fund, Medicaid Block Grant Proposal: What It Means for Kids
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