Vulnerable Youth in Foster Care Lose if We Let This Health Care Sequel Play Out

This year, I moved to Los Angeles after a long career in policy in Washington, D.C. I didn’t move here to work in the so-called “industry,” but boy, do I know a bad movie when I’ve seen one.

One of the worst is the latest GOP health care plan, which is a remake of an old tale from the 1990s. Shockingly, it even has some of the same aging stars.

Laurie Rubiner

In the original version, back in the days of Bill Clinton’s presidency, Rick Santorum was a young Republican senator from Pennsylvania leading the charge, alongside a group of Republican governors, to lend “flexibility” to entitlement programs by block-granting them to the states.

It was a grand scheme whereby states would no longer be bound to the individual entitlement to healthcare for the poor. Instead, the federal government would give the states a lump sum and “flexibility” to decide how many people to cover and what benefits to provide.

If Texas didn’t want to provide preventative screenings and services to children in the name of flexibility, then so be it. States gained latitude and the federal government saved money. The people who would suffer would be vulnerable low-income families and children.

Fortunately, there were a handful of Republicans at the time, and a majority of Democrats, who saw through this. They knew that flexibility was just another word for budget savings on the backs of the people who need help the most.

My late boss, GOP Senator John Chafee (Rhode Island), was one of those leaders who stood up for the vulnerable and opposed the Medicaid block grant. Thus, we were able to preserve critical entitlements, like guaranteed access to diagnosis and treatment for every single young person in foster care to provide for their often complex medical and developmental needs.

When I saw Rick Santorum, today a defeated senator and failed presidential candidate, helping Senators Lindsey Graham (R-South Carolina) and Bill Cassidy (R- Louisiana) champion another version of a Medicaid block grant proposal this week, I felt like I was watching a remake of that same bad movie from the 1990s.

I was brought right back to my time with Senator Chafee, championing low-income families and the more than 420,000 children in foster care who rely on Medicaid to meet their health care needs.

In the context of our current opioid crisis, enlightened leaders should be deeply averse to anything that reduces medical care for struggling families and medical intervention for children born with prenatal exposure that can impact their healthy development. (Senator Cassidy should know this better than anyone; he is a doctor who once set up nonprofit health centers in schools.)

The original 1990s storyline about efforts to limit Medicaid had a happy ending, thanks to a coalition that included Republican representatives willing to rise above partisan politics. We need to make sure the current remake ends the same way, and not in further tragedy for children in foster care and struggling parents.

Laurie Rubiner is president and CEO of the Los Angeles-based Alliance for Children’s Rights.

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