With health reform constantly under discussion in this country, the eligibility of children to qualify for Medicaid at various definitions of the federal poverty limit (ranging from 100% to 300% of the limit) are potentially threatened. If the eligibility were lowered from 300 to 200 and perhaps to just 100% of the poverty level, what would that mean for those no longer eligible for public insurance and yet facing hospitalizations for their child? It would mean huge numbers of hospitalizations no longer covered by Medicaid, shifting the costs to families (who would not be able to pay), other insurers (who won’t want to pay) and hospitals (who need the funds) leading to a potential health care economic crisis amounting from 1 to 4 billion dollars since up to 1 out of every 6 children hospitalized would have no source of payment. This is the take-home message from a simulation modeling study based on 2014 databases on hospitalizations of children in 14 states by Bettenhausen et al. (10.1542/peds.2017-3486) being early released this week in our journal. To better understand why this study is so important in our current health care climate, we asked Dr. Chris Landrigan from Boston Children’s to share his expertise on the implications of this study (10.1542/peds.2018-1549).
Dr. Landrigan provides a convincing case that while the government might think lowering its costs in the short run by reducing their need to finance health care at what they consider higher income limits above the poverty level, it is winning a battle but will shortly lose a war. In other words, over time there will be rebounding greater health care expenses as those living in or near poverty end up sicker and increase health care costs even more because of their inability to seek preventive health care services without adequate health insurance. Rather than worsen the disparities gap in health care that already exists, Dr. Landrigan calls for more funding of preventive services rather than reductions in health care funding from those families who need it most. Do you agree with the findings in this study and Dr. Landrigan’s ominous predictions if Medicaid eligibility is restricted in the next few years? Share with us your thoughts via this blog, sharing a comment on our website, or posting your take on this article and commentary on our Facebook or Twitter sites.