ROBERT SIEGEL, HOST:
The U.S. Senate's plan to replace the Affordable Care Act has many lawmakers, doctors, hospitals and patients worried. One big concern is that the Republican bill cuts funding for Medicaid dramatically over the next decade and beyond. From member station WBUR in Boston, Martha Bebinger looks at what that would mean for some kids who already start out vulnerable.
MARTHA BEBINGER, BYLINE: Chief of newborn medicine at Tufts Medical Center, Dr. Jonathan Davis, stands in the hospital's neonatal intensive care unit, or NICU, among babies who weigh as little as 1 pound. Sixty percent of these infants are covered by Medicaid.
JONATHAN DAVIS: Where in this bill is the protection for children?
BEBINGER: Davis pauses in front of an incubator that holds a tiny girl born just over 24 hours ago. You can see her ribs pumping several times a second.
How's she doing?
DAVIS: She's doing OK. The fact is she's in room air, so she's breathing entirely on her own, which is great.
BEBINGER: Doctors and nurses will work round the clock to give this baby and her roommates the best possible start. But Davis worries. Would Tufts be able to provide this care for free if the baby or her mom did not qualify for Medicaid and left the hospital uninsured?
DAVIS: Because if those children don't get home - go home and get great primary care, follow-up, early intervention and support, all those gains that they could potentially have made are going to be lost.
BEBINGER: That threat seems likely under the Senate health care bill, says Blue Cross Blue Shield Foundation of Massachusetts President Audrey Shelto.
AUDREY SHELTO: It is even more devastating than the House bill for low-income and vulnerable populations.
BEBINGER: That's because the Senate bill would leave more Massachusetts residents uninsured than the House bill would. The Urban Institute says the Senate bill would cost Massachusetts about $11 billion over the next decade. Supporters of the GOP health care bill say it's time to trim health care spending, and their proposals give states more flexibility. But Massachusetts State Senator James Welch says the state would have no good options.
JAMES WELCH: You know, do you raise taxes somewhere? Do you cut back on eligibilities? Do you cut back on benefits? Tough decisions are going to have to be made, but health coverage that children are currently receiving - we'll fight tooth and nail to make sure that that continues.
BEBINGER: The state's Republican governor has told GOP leaders on Capitol Hill their bills would strain the state's resources and destabilize the insurance market. Democrats in Massachusetts including State Representative Jeff Sanchez are more blunt.
JEFFREY SANCHEZ: They talked about repeal and replace. This is more like search and destroy because fewer people are going to get coverage that they need, and people will pay more out-of-pocket.
BEBINGER: For kids with disabilities, there's a possible bright spot in the Senate health care bill. About 20 percent of children who qualify for Medicaid because they are severely disabled would be exempt from the cuts.
KAYLA KLEIN: Right, Robs? Where's your port? Where's your port? Where is it? Where is it? Where is it?
BEBINGER: Kayla Klein tugs at the dog on her son Robbie's T-shirt. It hides a central line port through which Robbie gets medicine every day that tells his blood to form clots.
ROBBIE KLEIN: Right there.
K. KLEIN: It looks good - looking good.
BEBINGER: Robbie, who's 2 and a half, has hemophilia. Medication to treat the disease costs about a million dollars a year. Robbie has private insurance through his parents. Medicaid covers costs that insurance plan doesn't. It's not clear if Robbie would still qualify for Medicaid under the Senate's plan. Robbie's parents, Joel and Kayla Klein, both public school teachers, are really worried.
JOEL KLEIN: Our futures and our livelihood, you know, is hanging in the balance.
K. KLEIN: It makes you feel very fragile, makes you feel like you aren't empowered when your child's life is at stake.
BEBINGER: Senate Majority Leader Mitch McConnell is working to secure enough Republican support for a vote in the next few weeks. For NPR News, I'm Martha Bebinger in Boston.
SIEGEL: And that story is part of a reporting partnership of NPR, WBUR and Kaiser Health News.
(SOUNDBITE OF LOCAL NATIVES SONG, "WIDE EYES")
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