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Here’s a scenario that keeps adoptive and foster parent Sara Pendleton up at night: A child falls ill. The doctor is too expensive. Perhaps the child’s parents reduced or cut their coverage because the subsidies that allowed them to afford health insurance expired. Perhaps she got kicked out of Medicare or Medicaid after the GOP slashed that coverage. Whatever the reason, a policy choice forces mom and dad to keep the child home and hope for the best.
The child’s condition worsens. Her parents fear she may die. They take her to the emergency room, their last resort for some treatment. Doctors there give her the medicine she needs. They excoriate the parents, telling them their daughter needed care earlier. Now she has a host of complications that could have been prevented, they say, possibly lifelong ones. Then they call Child Protective Services.
This isn’t just a hypothetical flash of anxiety. Pendleton has seen it happen. She’s fostered dozens of children, including those with disabilities and medical complexities. Children in foster care have the highest rate of chronic conditions of any child population.
Insurance makes it possible for parents to manage a child’s disability, or to keep up with therapy, or even to simply attend to an illness promptly. Children without health insurance are vastly more likely to die if they fall ill, as medical scholars have pointed out for decades. Researchers in 2010 published an analysis of 23 million pediatric hospitalizations, for example, showing that nearly 40 percent of the uninsured children who died would still be alive if they’d had insurance.
Even before cuts to Medicare and Medicaid in the One Big Beautiful Bill Act, millions of children were tossed out of Medicaid and the Children’s Health Insurance Program. The end of enhanced Affordable Care Act subsidies put in place in 2021 means that at least half a million more children will lose their marketplace coverage, according to Georgetown University. Congress is holding votes this week to extend those subsidies that are not expected to pass.
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