Children’s health care is in danger | An already fragile system can’t withstand Republicans’ cuts

> This summer, Congress passed the One Big Beautiful Bill Act, Donald Trump’s sweeping second-term domestic legislation. The bill does not cut Medicaid, the White House insists. It slashes taxes and offsets the revenue losses by tamping down on what Republicans describe as waste, fraud, and abuse in the health-insurance program.

> Yet the Congressional Budget Office foresees that the law will drain close to $1 trillion of Medicaid’s financing in the next decade and cause 11 million Americans to lose their insurance coverage. Experts anticipate a cascade of effects. Private-insurance premiums and medical-bankruptcy rates will climb. Wait times for appointments with specialists will rise. Care deserts will expand. Hospitals and clinics will have to shut down. The most fragile sectors of our health-care system will be in danger of collapsing. And pediatric care might be first on that list.

> The law does not target children’s-health coverage or children’s-health initiatives. But nearly half of American children are enrolled in Medicaid or the related Children’s Health Insurance Program. If the One Big Beautiful Bill Act goes into effect as written, sick babies will end up paying for tax cuts for the wealthy.

> The bill “strengthens” Medicaid, as Republicans put it, by stripping insurance coverage from adults. For the first time, the country is implementing a nationwide work requirement for the program. Any state with an expanded Medicaid initiative (meaning that the state offers coverage to all low-income adults, not just those with a disability or another qualifying condition) will have to verify that enrollees are working, volunteering, or attending school, and kick them off the rolls if they’re not. The work requirement is not expected to spur more people to get a job; studies have found that nearly every adult on Medicaid already works if they can. But states will have to spend millions of dollars to implement it, diverting cash from delivering actual health care. And 8 million Americans are predicted to lose coverage as they struggle to keep up with the paperwork. The bill also contains a series of technical changes to Medicaid’s financing, altering the taxes that states levy on medical providers and the payments they make to them.

> Experts warn that dropping parents from Medicaid will mean dropping kids, even if those children continue to qualify in their own right. Parents are twice as likely to enroll their children in a public-insurance program if they are enrolled themselves, and states that cover a small share of low-income adults tend to cover a small share of low-income kids too. Already, more than 4 million American children lack health coverage. Hundreds of thousands more might join them in a year or two.

> A rising uninsurance rate among children is a crisis in and of itself. Kids without insurance are less likely to have a pediatrician monitoring their well-being and development. They’re more likely to be sick, less likely to get immunizations and prescription medications, less likely to be treated for severe health conditions, and more likely to be hospitalized. They are also more likely to die before reaching adulthood.

[more reporting on this](https://archive.is/gpEiS)

This is one of the great tragedies of “stove touching”, these aren’t just people’s paychecks but lives. It’s easy to look at budgets and numbers and separate treat them academicaly but they are so much more.