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By Michelle Hughes

NCChild15Once again, state lawmakers are prioritizing tax cuts over investments in children and families. The state budget proposal approved last week by the State Senate would cut $1 billion in taxes (mostly from upper income earners) while insufficiently funding children’s health, education, and security.

Now, Congress could the make a bad situation worse if it gives final approval to the massive Medicaid cuts recently approved by the U.S. House of Representatives.

The math is simple. The federal government currently pays about two-thirds of North Carolina’s annual Medicaid expenses. If the AHCA were to pass, the federal government would decrease the amount of support it provides by about $6 billion over the next 10 years. That will leave North Carolina with a decision to make—find an additional $6 billion in the budget or cut health services for children, the elderly, and people with disabilities.

Here are some examples of what’s at stake when we start talking about cutting Medicaid services:

* School-based health services, like mental health care, immunizations, and screenings for chronic conditions;

* Programs that keep people with disabilities in their homes rather than an institution;

* Hospice care for the elderly.

Under such a scenario, lawmakers would also likely be forced to cut reimbursement rates to providers, which would further decrease the pool of pediatricians, particularly specialists, willing and able to see children on Medicaid.

The current General Assembly is clearly uninterested in raising additional revenue, so it’s fair to assume that legislators would make up this $6 billion gap with cuts to health care and/or cuts to other areas of the budget, such as early childhood education, infant mortality prevention, K-12 schools, or other areas of the budget.

What could $6 billion in additional cuts mean for kids? The legislature could eliminate all state funding for all early childhood programs—including NC Pre-K, Smart Start, and child care subsidies—for the next ten years and not even be halfway to $6 billion.

If legislative budget writers don’t want to be forced into cuts like this in the future, then they should tell Senators Burr and Tillis to oppose capping and cutting Medicaid.

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