House health care plan would hurt N.C. more than most

The House health care bill would cut Medicaid. North Carolina would be hurt second-most in the nation, behind only Alaska, early analysis suggests.
The House health care bill would cut Medicaid. North Carolina would be hurt second-most in the nation, behind only Alaska, early analysis suggests. AP

Medicaid has been around for decades. It doesn’t grab headlines like the Affordable Care Act. It can be boring. It’s also terribly important for children’s health. And healthy children are key to our state’s future prosperity.

Thanks to the hard work of many, 96 percent of all N.C. children have health insurance. A little under half of those insured are covered by Medicaid – the workhorse of health coverage.

But the importance of Medicaid for children is too often overlooked in state and national health care debates. Block grants or per capita caps, as recently passed by the U.S. House, would hurt child health in North Carolina. At a recent meeting of primary care physicians, N.C. Department of Health and Human Services Secretary Mandy Cohen said early analysis suggests that North Carolina would be hurt most in the nation by these changes, second only to Alaska.

St. Clair

Some key facts to understand:

▪ When we talk about Medicaid, we are talking about kids. In North Carolina, 70 percent of all the people covered by Medicaid and Health Choice are children.

▪ Medicaid works well for N.C. children. Most N.C. pediatricians accept Medicaid. Thanks in part to the superb work of Community Care of NC, costs are below most other states while children covered by Medicaid enjoy some of the best screening rates and other care measures in the nation.

▪ Medicaid works well for U.S. children. National data show that children insured through Medicaid are more likely to reach their full potential – missing fewer days of school due to illness, doing better in school, graduating high school more often, growing into healthier adults, earning higher wages and paying more in taxes than children without insurance.

In February, pediatricians from every state went to Washington, D.C., to deliver one clear message to Congress: keep our federal health care structures strong for children. Without exception, every person I met with on the Hill understood the importance of health care for kids. Yet the House just passed a bill that would cut funding for non-disabled children insured by Medicaid by $1.2 billion by 2026 and with deeper cuts when you count kids with disabilities. Given the budget debates going on at the state level now, I don’t see the state making up those shortfalls.

Medicaid is an essential part of our health care infrastructure. Keeping it strong for kids is important for our state. We call on Sens. Richard Burr and Thom Tillis to ensure that whatever health reform passes the Senate protects child health.

As president of the N.C. Pediatric Society, I hear from my colleagues across the state who are struggling. Funding for pediatric care has already declined 30 percent in the past two years; clinics are closing and pediatricians are moving out of practice when payments don’t cover the rent. As a small business owner myself, I feel these pressures every day. Many experts say that federal changes are expected to significantly reduce funding to states for Medicaid. That would not bode well for kids or the health professionals who care for them.

W. Scott St. Clair, MD, FAAP is a pediatrician in private practice in Boone. He is president of the N.C. Pediatric Society.