Access to affordable, timely health care is a critical component of our quality of life. At Idaho Voices for Children, a nonprofit program that advocates for children, we are particularly interested in ensuring health coverage for kids and their parents.
As we enter the next wave of national health care reform, we want to make sure coverage gains are sustained and affordability is improved. Earlier this month, we got to see the first proposal that could replace the Affordable Care Act. The nonpartisan Congressional Budget Office analyzed this bill, called the American Health Care Act. The resulting data raise significant alarms about how the proposed policy will affect children and families. Nationally, the bill would cause more than 24 million people to lose their health coverage by 2026, while health insurance premiums rise 15 to 20 percent.
Your Health Idaho is our state’s health insurance exchange, providing health plans to 106,000 Idahoans (including 12,000 children). The majority rely on the Affordable Care Act’s tax credits to purchase these plans. Under the AHCA, tax credits to purchase health insurance will diminish in value and will no longer be based primarily on a family’s need. The bill would force almost 60,000 Idahoans off the state health exchange by 2020, according to Your Health Idaho. Your Health Idaho estimates that the average tax credit under AHCA would be $2,956 for an Idaho family of four with an annual income of $50,000. That is a 23 percent decrease in support from today’s benefit. Those coverage losses are deeply concerning.
We were also troubled to see our longstanding Medicaid structure get swept up into the debate around health care reform. This has a huge impact on kids because children without disabilities are the largest group of enrollees in Idaho’s Medicaid program, followed by children with disabilities. Idaho Medicaid provides early developmental screenings, dental care and other vital medical services that low-income children might not otherwise receive. The AHCA puts medical treatment for kids at risk.
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There’s also a fiscal risk to our state. Idaho Medicaid is lean and efficient, with costs growing much more slowly than private health insurance. Since Medicaid was enacted decades ago, Idaho has been able to weave matching federal funds together with our state investment. This risk-sharing works well and provides incentives that effectively control costs.
The AHCA would put a “cap” on the current Medicaid program, which shifts the risk of any unexpected cost growth completely to our state’s general fund. That’s the same revenue source that funds schools, higher education and public safety.
As Gov. Doug Ducey, R-Arizona, wrote to congressional leaders, this change to Medicaid financing “will result in the single largest transfer of risk ever from the federal government to the states.”
We are ready to embrace change to improve our health care system. Unfortunately, the AHCA creates new problems and brings enormous risks to our kids, our families and our state.
Jesus Blanco is the policy and outreach associate with Idaho Voices for Children, and previously worked in primary health care.