By Denise Tanata
Senator Heller will demonstrate in the coming days whether he stands with the people of Nevada, including our children, or with his leadership in Washington. His vote to allow the Senate to move forward with repealing and replacing the Affordable Care Act (ACA) has jeopardized health insurance for tens of thousands of Nevadans, including many of our state’s poorest children. Senator Heller can and must act to prevent the children of Nevada from losing affordable, comprehensive health insurance.

Health care is a basic ingredient for a child’s well being.

To be healthy, children need regular checkups, immunizations, access to care when illness arises, and ongoing monitoring to identify potential health problems early.
We did not know exactly which bill the Senate would vote on. “It’s a surprise” is not an acceptable answer when we ask our senators what changes they are making. But every version of the proposed health care bill would have slashed Medicaid.
48% of all Medicaid and Children’s Health Insurance Program (Nevada Check-up) enrollees in Nevada are children. This connects them to vital health services that promote healthy development.  The Affordable Care Act—which expanded coverage to many more low-income working parents—has also increased insurance for kids. This is a stunning achievement for our state. The annual Kids Count Data Book, released last month, ranked Nevada 47th overall for child wellbeing. However, one of the significant bright spots among our state indicators was the share of children with health coverage. Just 8% of Nevada’s children are uninsured today, down from 17% a few years ago.  Nevada’s children cannot go backward on this critical indicator. It’s estimated that passing the latest Senate proposal will cause 51,000 Nevada children to become uninsured, a 62.7% increase.

The core of the bill is deep and permanent cuts to the Medicaid program that would result in millions of people losing coverage.

The bill limits federal funding to states, undermining the guarantee of comprehensive medical insurance that exists in Medicaid today. Nevada currently spends less than any other state per child receiving Medicaid; the Senate bill would lock in this disparity.  It would also end the Medicaid expansion, which has allowed 203,900 Nevadans to gain access to health coverage. Governor Sandoval has estimated that the cuts to federal support for Medicaid expansion alone would require Nevada to contribute an extra $480 million a year, starting in 2024, to continue coverage.  This is over 10% of the state’s general revenue. Over time, federal funding cuts would get even deeper, resulting in unprecedented strain on the state budget. This, in turn, would squeeze state funding for other services. States would be left holding the bag for health care costs—forcing state policymakers to choose between funding health care for children and other critical services.
Many who gained health coverage under the expansion were low-income parents whose jobs do not offer insurance, who were unable to afford private insurance, and who were not eligible for Medicaid prior to the ACA. Ending the Medicaid expansion—and leaving hundreds of thousands of Nevadans without coverage—harms not only those parents but also their children.

Children grow and develop in the context of their relationships with adults.

Because parents’ and children’s well-being is so inextricably linked, the loss of necessary health and mental health services can have long-term, dire consequences for both parties. Parents’ untreated physical and mental health needs interfere with success in the workplace and with parenting, affecting young children’s development and contributing to challenges in school readiness and educational success.
Kids can’t vote, but Senator Heller faced a vote that would have impacted the lives of Nevada’s children for decades to come. Last month, Senator Heller said he could not support a bill that would take away health insurance from tens of millions of Americans and hundreds of thousands of Nevadans.  The bills that were being considered would have done just that. Senator Heller must do the right thing for kids going forward: protect Medicaid and vote “no” on any future effort to repeal and replace the ACA.
Denise Tanata is Executive Director of Childrens’ Advocacy Alliance, a community-based nonprofit organization that mobilizes people, resources and reason to ensure every child has a chance to thrive, and to make Nevada a better place to live and raise a family.