March 8, 2017

Congress Begins Its Work to Ram Through Dangerous Changes to the Medicaid Program

The U.S. House intends to pursue an alarmingly expedited and non-transparent process to radically restructure the Medicaid program. To ensure the health and economic security of Florida families, key questions must first be answered.

Last week, the Georgetown Center on Children and Families (CCF) blogged about the U.S. House of Representative’s intention to ram through Affordable Care Act (ACA) “repeal and replace” legislation in an unprecedented non-transparent and expedited manner. The House Energy and Commerce (HEC) Committee is today “marking up” a bill that was released publicly less than two days before the committee starts its work. The mark-up will occur without any public hearings or analysis of the bill by agencies with Medicaid and budget expertise (e.g., Congressional Budget Office).

The bill not only repeals and replaces the ACA, but goes much further by cutting and capping federal Medicaid funding. This means that the Medicaid we know, and have depended on for nearly 50 years to take care of the most vulnerable Floridians, would cease to exist. Florida would be on the short end of the one of the biggest costs shifts from the federal government to the state.

The proposal is a serious threat to the health and economic security of Florida children and families.  The Medicaid program covers over 47 percent of all Florida children- 2 million – and 1.7 million adults – seniors, persons with disabilities, pregnant women and very low income parents.

CCF’s blog highlights the following key questions, which must be answered before the HEC Committee begins its work. Floridians’ health and economic security are at stake.

  • Medicaid is the largest health insurer for Florida’s children, including those with disabilities and special needs. How many of those children will lose their guarantee of coverage under the House proposal? How will the loss of coverage affect their health and their families’ economic security?
  • Medicaid is the largest insurer for Florida births. The program covers 63 percent of all deliveries in the state ensuring a healthy delivery and strong start during an infant’s critical first year of life. If federal Medicaid payments are capped, will pregnant women and new mothers and their babies still have a guarantee of coverage?
  • Medicaid offers a child-centered benefit package that covers all of the screenings and treatments recommended by pediatricians. If federal Medicaid is capped, what will happen to these benefits and the children who rely on them for healthy development?
  • Medicaid is the largest source of federal funding for Florida’s budget. By capping federal Medicaid payments, how much will be cut from the state budget? How will those cuts limit Florida’s ability to keep children and families covered?
  • If Medicaid funding is capped, will Florida’s Medicaid eligible children be able to keep their doctors and continue to be cared for by local hospitals, teaching hospitals, children’s hospitals and centers of excellence? Will they be able to continue to serve as community resources for children and families?

The answers to these questions have pervasive implications for the state and for the health and well-being of residents. Policymakers have an obligation to make the proposed legislation public and incorporate full and open input in the best interests of the constituents they serve. As we know in Florida, sunshine is the best disinfectant.

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