Children's Health at Stake in Budget Cuts

By Alan W. Brass and Harvey R. Colten | St Louis Post-Dispatch (MO), April 7, 1995 | Go to article overview

Children's Health at Stake in Budget Cuts


Alan W. Brass and Harvey R. Colten, St Louis Post-Dispatch (MO)


The federal government is talking about balancing its budget, while state governments already have to. Getting budgets in balance means government must eliminate expenses and reduce the future rate of growth. As children's advocates, we recognize the value of controlling debt and we support strengthening the economy, in part because that will mean a stable future for families and children.

We don't want the impact of balancing budgets to fall disproportionately on programs designed to benefit our youngest citizens - programs like Medicaid, which is essential to one in four children, yet represents only a small fraction of total state and federal spending.

Medicaid is often thought of as a federal-state partnership providing health-care assistance for the poor. Few people realize that though it does provide certain types of supplemental support for the needy elderly, it is the medical safety net for all children.

Today's Medicaid is often the sole resource for millions of families whose private insurance is only as secure as a parent's paycheck. Without Medicaid, nearly half of all children under age 6 would be uninsured.

The image of a single woman with multiple children as the prime benefactor of Medicaid funding is a popular misconception. That picture unfairly forces Medicaid into discussions of welfare programs and endangers its future as a medical-care resource for children in millions of working families with low income. Approximately 60 percent of Medicaid-covered children (under age 18) live in working families.

Two concurrent movements have the ability to undermine the support families count on for their children's medical needs: congressional determination to dismantle federal programs and state plans to remodel Medicaid.

Many on Capitol Hill are proponents of state-managed assistance programs. Yet those who favor passing some responsibilities to the states want to retain federal jurisdiction over services for the elderly and disabled. Why should children, who can't vote, see their interests buried in discussions about dollars?

In Missouri, children are about a quarter of the population yet they make up about 55 percent of those eligible for Medicaid assistance.

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