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Kristen Golden Testa's picture

In the discussion about the national debt, the moral imperative of not saddling our children with debt is frequently heralded.  It makes perfect sense that the current generation should find ways to manage finances wisely to avoid such a scenario.  It also makes sense that we should make investments to provide children with the ability to grow up to be healthy and productive.  What doesn’t make sense is to rob today’s children of the health care they need in order to achieve unrelated goals of balanced budgets—and this is exactly what a debt reduction scheme like the global spending cap would do. This proposal, in fact, would plunder two key health programs: Medicaid, which covers 30 million children, and CHIP, covering an additional 8 million children.

Recently, we have witnessed a never-ending array of assaults aimed at health programs that provide the preventive and medical care kids need in their formative years. We’ve heard a lot about the Ryan plan to change Medicaid to block grants – a move that would endanger the health care of approximately 1 in every 3 children in the United States who receive health care through that program.  The major flaw of this proposal is evident: Medicaid block grants merely shift costs to the states, adding a huge burden on the already budget strapped states, or forcing them to cut health care coverage to children.

When proposals cut children’s health programs, voters make it clear they don’t want kids to bear the budget burden now or in the future. According to an April poll commissioned by First Focus, voters by a 2:1 margin disapprove of providing governors with more flexibility if it means eliminating insurance coverage for some children. And a recent Washington Post poll demonstrates that the public overwhelmingly disapproves of cuts to children’s health care, as nearly 70% do not support cuts to Medicaid funding.

So now that American voters have weighed in, the attempt to cut children’s health programs is threatening to come in the backdoor—all dressed up in the ethic of protecting future generations from debt.  The untold story about the global spending cap is that it would eventually have the same devastating effect upon children’s health as the Ryan budget proposal. Such proposals will not specify turning Medicaid into block grants. They don’t have to.  It is virtually impossible to make cuts this deep without eventually converting Medicaid to block grants. Budget reduction experts agree that proposals such as a global spending cap can permanently undermine the system of coverage for many children under the guise of “helping” them down the road.

Parents, doctors, nurses, teachers and all advocates for children need to rally against these indirect threats as well as those more “front and center.”

There are two sets of negotiations creating pressure to pass some form of global spending cap legislation: The federal debt reduction proposals and raising the federal debt ceiling --- both close at hand. The work is upon us all to educate policy makers about the consequences for children of both the clear and present dangers from proposals like the Ryan budget, as well as the more obscured dismantling of health programs through global spending caps.

Make no mistake, these apple-pie sounding deficit proposals can be the backdoor in to decimate essential programs for children’s health. Those who truly value the well-being of American’s future generations should do all they can to oppose them today.

Kristen Golden Testa is Director of the California Health Program at The Children’s Partnership, which advocates for improvements in child health care.


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