The U.S. Senate鈥檚 plan to聽聽now in , would cut funding for Medicaid and other health insurance subsidies by more than $1 billion a year within five years. That has聽, doctors, hospitals and patients across Massachusetts in a state of alarm.
鈥淲here in this bill is the protection for children?鈥� asked聽, the chief of newborn medicine at Tufts Medical Center, as he stood in the hospital鈥檚 NICU among babies who weighed as little as 1 pound. Roughly 60 percent of babies in the Tufts NICU are covered by Medicaid.
Davis paused in front of an incubator that held a tiny girl, just a few days old, who weighed 2.5 pounds. Her little lungs pumped several times a second.
鈥淭he fact is, she鈥檚 in room air, so she鈥檚 breathing entirely on her own 鈥� which is great,鈥� Davis said.
Doctors and nurses work round-the-clock to give this baby and her roommates the best possible start. But it鈥檚 unclear whether Tufts could provide this care for free if the baby or her mom didn鈥檛 qualify for Medicaid. Davis said they also need good health coverage after they leave the hospital.
鈥淏ecause if those children don鈥檛 go home to get great primary care, follow-up, early intervention and support, all those gains that could potentially have been made are going to be lost,鈥� Davis said.
That threat seems real under the Senate health care bill, said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts聽Foundation.
鈥淚t is even more devastating than the House bill for low-income and vulnerable populations,鈥� Shelto said.
That鈥檚 because, as of 2025, the Senate would tie spending for each person on Medicaid to a standard inflation rate, instead of the rate of medical inflation, which is usually higher. In Massachusetts, lots of lawmakers 鈥� Democrats and Republicans 鈥� are frustrated, if not angry.
State Rep. Jeff S谩nchez, House chair of the聽, reviewed the details on his way to a health care conference.
鈥淭hey talked about repeal and replace,鈥� he said. 鈥淭his is more like search and destroy 鈥� because fewer people are going to get coverage that they need, and people will pay more out-of-pocket.鈥�
S谩nchez says Massachusetts has a longstanding practice of making kids a priority and has enhanced MassHealth to make sure kids in low-income families get the care they need.
鈥淣obody鈥檚 clear on what鈥檚 the future of that program,鈥� he said. 鈥淓verything is up in the air.鈥�
S谩nchez鈥檚 co-chair, state Sen. James Welch, has called the U.S. Senate bill 鈥渃lass warfare鈥� because it would take money from poor kids and their moms and give it to wealthy adults in the form of tax cuts. But Welch says the state won鈥檛 have any good options if Massachusetts has to make up聽聽in the future.
鈥淒o you raise taxes somewhere? Do you cut back on eligibilities? Do you cut back on benefits? Tough decisions are going to have to be made,鈥� Welch said. 鈥淏ut health coverage that children are currently receiving 鈥� we鈥檒l fight tooth and nail to make sure that continues.鈥�
, president of the Massachusetts Taxpayers Foundation, says the state should cut health care spending before any talk of raising taxes or moving people off Medicaid. But McAnneny says MassHealth, the state鈥檚 Medicaid program, is growing faster than the state can manage. About 60 cents of every new tax dollar goes to MassHealth.
鈥淪o we have to reduce the cost of the MassHealth program, or the state will deliver MassHealth services and few others because it will consume a lot of our resources,鈥� McAnneny said.
For kids, there is one bright spot in the Senate health plan that is not in the House Obamacare replacement bill: About 20 percent of children who qualify for Medicaid because they are severely disabled would be exempt from the cuts.
Kayla Klein, of West Roxbury, is watching what Congress is doing closely. She tugs at the appliqu茅d dog on the front of her 2-year-old son Robbie鈥檚 T-shirt.
鈥淩ight, Robs? Where鈥檚 your port?鈥� she asks, playfully.
Robbie鈥檚 T-shirt hides a central line port through which he gets medicine every day that he needs to stay healthy; he has the blood-clotting disorder聽.
Robbie makes his mom and dad, Joel Klein, laugh a lot. But they鈥檙e also very worried. Hemophilia medications can be聽, and the Kleins are both schoolteachers, without hefty salaries. Robbie has private insurance through his parents to cover most of the cost, and Medicaid fills in the gaps,
The Kleins want to make sure members of Congress understand the decisions they鈥檙e making are important.
鈥淥ur futures and our livelihood are hanging in the balance,鈥� Joel Klein said.
鈥淚t makes you feel very fragile. It makes you feel like you aren鈥檛 empowered when your child鈥檚 life is at stake,鈥� Kayla Klein added.
Senate leaders say they expect to vote on their health care bill before their August recess. It鈥檚聽聽whether the bill has the votes to pass.
This story is part of a partnership that includes , and Kaiser Health News.
KHN鈥檚 coverage of children鈥檚 health care issues is supported in part by a grant from .