Why are we even thinking about a health care bill that hurts children?

Where is the conscience of America? Why would we think of hurting our children?

The Senate health care bill shouldn’t be called the Better Care Reconciliation Act; a better name would be the Bad Care Reconciliation Act. And you know who it’s really bad for? Children.

As a pediatrician, I am embarrassed to be part of a country that would hurt children purely for political gain. Because let’s get real: the only reason Republicans are pushing this legislation is because they think it’s better to do something than nothing. They said they’d repeal and replace “Obamacare,” and they figure that not doing it makes them look weak and ineffectual.

Apparently being cruel is better than being weak and ineffectual.

Currently, there are 37 million children on Medicaid in the US, more than half a million here in my home state of Massachusetts. The Bad Care Reconciliation Act—actually, maybe we should just call it the Bad Care Republican Act, since no Democrat wants it—would cap Medicaid as of 2020, leaving it to states to deal with all of the fallout.

And there would be lots of fallout.

As a pediatrician working in Boston, I see lots of children on Medicaid. Medicaid is the only way they can get health care, with everything that means: shots, sick visits, medications, visits to specialists, mental health care…everything. There is no way their families could afford any of it without Medicaid. For my medically complex patients, anything that lessens Medicaid coverage could be especially devastating. Not only is Medicaid how they get their life-saving medical visits and medications, Medicaid is how they get their gastrostomy tube supplies, their wheelchairs, their specialized formulas, their home nursing and all the other crucial pieces of their care. Although there is talk of a “carve-out” for “disabled” children, whatever that means, if Medicaid is capped and the states are stuck with trying to meet everyone’s needs, that carve-out won’t do squat.

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The bill also moves children whose family’s income is between 100 and 133 percent of poverty out of Medicaid and into the Children’s Health Insurance Program (CHIP)—where full coverage for everything needed for well child care isn’t guaranteed. Way to go. This is how we invest in our future?

The fallout would include children who are less healthy, who aren’t immunized, can’t keep up in school. The fallout would include children with untreated conditions—which could mean permanent disability or even death. I’m not kidding. When you mess with access to health care, you mess with lives.

Speaking of families, many of those 22 million more people left uninsured by 2026, including those who have been able to use the Medicaid expansion, are parents. Not only does the health of a parent impact their ability to work, let alone parent, taking them off insurance could leave them unable to pay for food and housing should they get sick or injured and get stuck with medical bills. Talk about devastating for children.

There are just so many ways this act hurts people—don’t even get me started on the six-month delay in coverage for anyone who buys a policy after having at least a 63-day gap in coverage, what if that person has cancer?—that it stuns me as a medical professional. I’m not the only medical professional who is stunned; all of the major doctor and hospital groups have spoken out against it, including the American Academy of Pediatrics.

Our health care system has problems that need to be fixed—nobody is arguing that point. But this doesn’t fix the health care system. This hurts the health care system—and hurts people, especially vulnerable people like children.

It’s embarrassing, it’s cruel, it’s wrong. Where is our conscience? Who have we become? Are we really going to let this happen?

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