On Thursday, Senate Republicans who had been hammering out the details of their health care bill to repeal and replace the Affordable Care Act in a secretive process finally shared the text of the proposed legislation with the American public. And the so-called Better Care Reconciliation Act is exactly the monstrosity that many progressives feared it would be, with its significant built-in tax relief for the rich juxtaposed against its punishing, potentially devastating cuts to Medicaid and other features that helps people access care under the current law. So many people would be hurt by this latest version of the Republican answer to the ACA, which is former President Barack Obama’s signature health care legislation. And perhaps one of the most egregious, callous examples is how the BCRA would affect kids with disabilities — because, if passed in the vote that’s reportedly slated for next week, it would hit them hard.
The BCRA would dramatically slash federal spending on Medicaid, which provides health care to poor Americans, by adopting a “per capita cap," according to Vox. Essentially, the federal government would no longer match state spending on the program — and this will ultimately cut Medicaid funding for the neediest of Americans by “hundreds of billions” of dollars over the next decade.
This would all but certainly negatively affect disabled people of all ages, not just children, because so many of them rely on Medicaid funds to access services and treatments that are vital to their well-being and independence.
As if that weren’t bad enough, there’s another cost for children who are enrolled in special education programs. The New York Times reported in May, right around the time that the House version of the bill passed, that the repeal of the Affordable Care Act and the Medicaid cut that was sure to come with it, would target special needs kids in schools. At the time, Erica L. Green of the Times wrote that Medicaid has helped to foot the bill for special education services like therapists, equipment, and even preventive care for the past 30 years. But with the looming passage of the BCRA, all that could change.
To that end, a school superintendents association called the AASA released a statement warning against the House bill, called the American Health Care Act, in late April. It argued against the Medicaid cuts:
A per-capita cap, even one that is based on different groups of beneficiaries, will disproportionately harm children's access to care, including services received at school. Schools are often the hub of the community, and converting Medicaid's financing structure to per-capita caps threatens to significantly reduce access to comprehensive health care for children with disabilities and those living in poverty. We urge Congressional leaders to reject the American Health Care Act.
Congress, of course, did not reject the American Health Care Act — it passed it and advanced the work of repealing the ACA over to the Senate. The Republican members of the House did this despite knowing the implications it would carry for disabled children. Now, shamefully, the Senate is poised to do the same. Still, even as the GOP must to amass the necessary 50 votes, and not all senators are on board.