Pediatricians Blast Trumpcare for Lifetime Coverage Caps

The passage of the American Health Care Act in the U.S. House of Representatives has drawn criticism from the American Academy of Pediatrics, one of the dozens of medical organizations to release statements condemning the bill. The AAP’s stance on the bill is unsubtle and unequivocal: The group of 64,000 claims the AHCA will prove devastating and potentially deadly for children across the United States currently covered by the Affordable Care Act. Though the group objects to numerous elements of the bill, a provision that would allow insurers to reinstate lifetime caps on coverage is a particular point of contention.

“A lifetime cap just doesn’t make sense for a child who has chronic medical conditions,” AAP Fellow and past DC chapter president Dr. Lee Beers told Fatherly. “Even children with short-term, acute and very serious conditions requiring hospitalization and follow-up care are in a terrible position for the rest of their lives.”

The reason for this, she explains, is because a lifetime cap in coverage for the most vulnerable sick kids is quickly reached. In some cases, a child born with a medical condition could reach their lifetime cap before even leaving the hospital.

“Children with chronic health conditions do better, and are considerably more likely to thrive if they have access to good health insurance,” Beers says. “And if their families are having to make choices about rationing care or not having access to care, that really has tremendous and life-altering downstream effects.”

But Beers points out that lifetime caps aren’t just a danger for kids with relatively rare but devastating conditions, like cystic fibrosis and cancer. In fact, the caps could be awful for kids with even the most common chronic childhood medical condition: severe and persistent asthma.

“They’re required daily medication. They’re required routine visits. They’re also having serious exacerbations that require admittance to the intensive care unit,” Beers says. “You can imagine that would spend down the lifetime cap pretty quickly.”

Beers explains that families choosing to ration care because of these conditions are already vulnerable. She works in Washington DC where she cares for children from surrounding states that don’t have comprehensive health coverage, and she’s seen parents making hard choices about their kid’s healthcare. These include declining recommended diagnostics tests.

Released moments after the bill’s passage, the AAP statement on Trumpcare suggests Medicaid caps, and the elimination of Medicaid expansion, jeopardizes the current coverage of nearly 37 million kids who rely on the program. Moreover, the statement condemns the AHCA’s rollback of protection for pre-existing conditions and the possible reinstatement of lifetime caps on coverage, which would be particularly devastating for young children with serious health conditions.

Because of the AHCA’s possible adverse consequences, Beers notes that the AAP will lobby the Senate and policy makers who now hold the fate of American children in their hands. But she says that everyday citizens have a responsibility of their own.

“Educate yourself and really learn what the proposed changes would mean for you, your family, your neighbors, and friends,” Beers says. “That’s the way that good information is spread.”