May 9, 2017 Andy Schneider Late last week, the House of Representatives, with one vote to spare, passed a bill to “repeal and replace” the Affordable Care Act (ACA). Among many other things, the bill would radically restructure the nation’s largest health insurer for children—Medicaid—by capping federal matching payments to states starting in three years and continuing each year after that in perpetuity. For over 50 years, the federal government has matched state Medicaid spending on health and long-term care services for children and other vulnerable populations. Under the House bill, those days would be history, and the federal government would have a new budgeting tool to dial down for “savings” by shifting costs to the states. It’s hard to overstate how damaging this change will be to children’s coverage, to their health, and ultimately to their life chances. (I’ve tried, but words have failed me). And even though the 34 million children in Medicaid represent o
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