When the U.S. House passed the American Health Care Act (AHCA) earlier this month, GOP lawmakers made it painfully clear that they intended to cut and dismantle Medicaid as we know it. Cuts to Medicaid as proposed by the AHCA would shift more than $6 billion dollars onto North Carolina state government  as the proposal dismantles Medicaid’s current funding structure and devolves it to a “per capita” cap or block grant. Such massive cuts would put the lives of two million North Carolinians at risk, most of whom are children. Nationally, the AHCA would cut federal funding by 25 percent over 10 years and end coverage to 14 million people across the U.S.
Now, if that isn’t bad enough, Trump’s newly released budget proposes to dramatically expand those damaging cuts. Indeed, Trump’s budget would cut Medicaid by an additional $610 billion. Together, Trump’s budget and the AHCA would cut Medicaid in half  (or by $1.4 trillion). Elizabeth G. Taylor of the National Health Law Program  put it this way:
“In times of great economic inequalities, the president’s budget is wildly out-of-touch, cynical and cold-hearted. Medicaid, regardless of political rhetoric, is a popular and effective health care program for low-income individuals and families and provides quality care to more than 30 million children. The program is integral to health care providers, professionals and hospitals who provide care to Medicaid beneficiaries. These cuts, if enacted, would harm tens of millions of people, and to what end? Shrinking the federal government is not a sufficient justification when millions will suffer.”
Needless to say, such massive cuts will have devastating impacts on North Carolina’s Medicaid program. Drops in federal funding for Medicaid will force North Carolina to make difficult/impossible decisions. To maintain coverage for the state’s most vulnerable  (children, people with disabilities, and older adults) North Carolina will have to raise taxes or make draconian cuts — to provider payments, benefits, enrollment or all of the above.
To make matters even worse, Trump’s budget also goes after a program that has long enjoyed bipartisan support, the Children’s Health Insurance Program (CHIP), as it cuts approximately $6 billion from that program. On top of that, it only assumes that CHIP exists at all through 2019. Together, the proposed cuts to Medicaid and CHIP threaten the well-being and healthy development of North Carolina’s children. More than one million children rely on Medicaid and CHIP. These programs help North Carolina’s most vulnerable children – these are children in foster care, living in poverty, and children with disabilities.
Trump’s budget claims to put taxpayers first, but, this is a disastrously shortsighted claim. The truth, of course, is that children with Medicaid coverage have higher education attainment, get better jobs and are much more likely to grow up to be successful tax-paying adults . Tragically, this obvious and simple connection appears to be too much for the President and his allies in Congress to grasp.