Robert Meyer is president and CEO of Phoenix Children’s Hospital.

The impact of the Medicaid cuts proposed in the American Health Care Act (AHCA) have taken a backseat to political discourse surrounding pre-existing conditions and insurance subsidies. The American Health Care Act gained speedy passage in the House of Representatives and is now under deliberation in the Senate. While dialogue the past few months has focused on the impact the American Health Care Act will have on adults, it’s important to ensure the conversation moving forward encompasses Medicaid and the impact Medicaid cuts will have on children’s access to health care.

The current proposal slashes federal funding by $839 billion over 10 years. The cuts most certainly will affect millions of adults, seniors and those fighting complex or chronic conditions. Still, many Arizonans may not realize that Medicaid reform will also have a dramatic effect on our state’s sickest and most vulnerable children.

Currently, children comprise 50 percent of Medicaid enrollment, but account for less than 20 percent of the cost of the whole program. Children are not what principally drives up Medicaid costs, but the proposed cuts threaten to unravel health care for low-income kids as well as children who are fighting serious illnesses.


• Approximately 636,000 Arizona children depend on Medicaid for health care coverage through the Arizona Health Care Cost Containment System (AHCCCS), and KidsCare, the crucial program that covers children in families whose incomes fall just above the Medicaid funding threshold.

• In addition to low-income children, the Medicaid program covers medically complex kids who are partially covered by commercial insurance but rely on Medicaid to subsidize the cost of life-saving treatments and services. These children are fighting pediatric cancer, congenital heart disease, and other chronic illnesses requiring highly specialized care.

• As it is now structured, the AHCA threatens to cut federal funds to Arizona by $1.487 billion, which would create a ripple of harmful consequences that put our state’s youngest residents at risk.

Certainly, it’s important for our government to evaluate federal spending, improve efficiencies, and ensure the long-term solvency of programs like Medicaid. But, Medicaid for children has already proven effective and efficient. Moreover, when it comes to proposals that reduce Medicaid funding, children are completely lost in the conversation. Kids are not just small adults; their needs and opportunities are unique, and their health care must be treated differently.

For example, Medicaid’s core benefit for children – Early Pediatric Screening, Diagnostic, and Treatment (EPSDT)– is no longer required under the American Health Care Act. In fact, the bill doesn’t include any provisions that guarantee money intended for children will be spent on this population. Along with immunizations, mental health assessments, vision, eye and hearing exams, and other vital services provided by EPSDT, AHCA gives states the option of eliminating Essential Health Benefits and cost-sharing protections for families.

The non-partisan National Bureau of Economic Research published a study in 2015 showing the government recoups much of its investment in Medicaid for children in the form of higher future tax contributions. Children with access to health care through Medicaid are more likely to attend school regularly, graduate from high school and go to college, thereby becoming healthier adults who will earn higher wages than children who do not have appropriate health care as they grow.

As Arizona’s only health care system focused exclusively on children, we believe the Senate must strike down any proposal threatening funding, coverage and benefits for children.

Most states, including Arizona, are heavily reliant on Medicaid to care for low-income and seriously ill children. With significant cuts in federal funding, states like ours will be forced to do more with less. To be sure, this poses a real a threat to our kids, but it also compromises our families, communities and the future prosperity of Arizona.

Arizonans have shown time and again their commitment to our children. Now, more than ever before, we must renew that commitment to protect our youngest residents – our state’s greatest asset – and we ask our elected leaders to lead the charge in safeguarding their health and well-being.


Robert Meyer is president and CEO of Phoenix Children’s Hospital.