Tax Cuts, Budget Deficits, and Medicaid Cuts: Does “Starving the Beast” Mean That Children's Health Must Take Two Steps Backward?

Abstract

The Colorado experience with Medicaid published in this issue of Pediatrics 1 demonstrates how attempts to restrain the growth in Medicaid expenditures can restrict access to primary care and preventive services and ultimately increase per-capita Medicaid expenditures because of higher preventable hospitalization rates. This study deserves the attention of national and state policy makers because of the federal Conference Agreement on the Federal Budget Resolution that includes $10 billion in Medicaid and State Children's Health Insurance Program reductions. In many states these federal reductions are likely to derail needed increases in Medicaid payments for physician services to levels that at least cover overhead expenses. Do these budget reductions mean that we will be taking 2 steps back on the path to improving the lives of America's children as we address the consequences of our large and growing national deficit and the demographic impact of an aging population? These structural deficits and projections of future entitlement spending pit the needs of children … Address correspondence to Steve Berman, MD, Children's Hospital, 1056 E 19th Ave, B032, Denver, CO 80218. E-mail: berman.stephen{at}tchden.org