Flint and its water crisis offer a case study in the program’s value to children.
Republicans eager to justify the severe Medicaid cuts in their Obamacare repeal proposals have offered up a number of arguments. They say Medicaid doesn’t contribute to better health, or that it doesn’t offer value to its beneficiaries. They also say the proposed cuts would affect only able-bodied adults, sparing groups like low-income children that Medicaid has traditionally served.
Those claims don’t hold up well to scrutiny. Relative to people with no health coverage, Medicaid recipients end up more financially secure and have better access to care, according to a body of research that stretches back decades. And while the evidence of Medicaid’s health effects is more ambiguous, most well-respected experts believe it helps and, in the aggregate, may even save thousands of lives a year.
But for a more poignant demonstration of why repeal advocates are wrong about Medicaid, it helps to see the impact Medicaid can have on a community ― the different ways it supports vulnerable groups, especially children, and just how much those groups would suffer if Republican legislation were to pass.
One of those communities is Flint.
Most people know about the contamination of the city’s drinking water, which attracted national attention in the late summer and early fall of 2015. Few people know about the role Medicaid played in exposing it.
Residents began complaining about foul-looking and tasting drinking water shortly after state officials, who had taken charge of the city’s finances, decided to take water directly from the Flint River rather than from Lake Huron. But even after an outside researcher at Virginia Tech found evidence that the river water lacked critical anti-corrosive additives to prevent lead from leaching from the pipes, officials continued to insist the water was safe to drink.
That’s when Dr. Mona Hanna-Attisha, a pediatrician and public health researcher at the city’s Hurley Medical Center, started pulling blood testing data from the hospital’s electronic medical records. Those records showed that the number of children with above-average lead levels had risen by more than 100 percent since Flint switched its water source, with particularly high increases in certain zip codes.
The data existed because of Medicaid ― specifically, because of the program’s Early and Periodic Screening, Diagnostic and Treatment, or EPSDT initiative, which requires and finances extra medical testing for low-income children. Congress added EPSDT to Medicaid in the late 1960s, shortly after the program’s creation, because both Head Start programs and Vietnam draft boards were reporting high incidences of health problems that had gone undetected and untreated.
Lead, a toxin that causes severe, irreversible damage to the developing brains of young children, is precisely the sort of hazard EPSDT was designed to detect. Hanna-Attisha’s research drew national attention to the crisis, and after briefly attempting to deny her findings, state officials finally admitted she was right.
“Without that data,” Hanna-Attisha told HuffPost recently, “I have no idea where we would be.”
Today, Flint is back to drawing its water from Lake Huron, and the lead levels in the water supply are down, if not yet to where they should be. But Medicaid continues to play a critical role in the well-being of Flint’s children.
That’s partly because Medicaid is doing for Flint what it did for New Yorkers following the Sept. 11, 2001 attacks, and for Gulf Coast residents after Hurricane Katrina in 2005 ― serving as an emergency source of health coverage for anybody in need of help.
Thanks to a special waiver that state officials sought and federal officials approved after the crisis became public, Michigan’s version of Medicaid is now open to all Flint-area children and pregnant women in households with incomes up to four times the poverty line.