Remember Healthcare Access at the Ballot Box
By Mali Rauch ’22
I have gone to the same primary care physician for over thirteen years. When I walk into Steeplechase Pediatrics at age sixteen, I am the tallest patient by feet watching cartoons in the lobby. I have never been to a doctor’s office without zoo animals painted on the walls. Every year, I drive an hour to Rodeo Dental, a themed dentist’s office nestled between a Fiesta Mart and a Goodwill, with slides and an arcade in the entrance.
When, after years of depression and anxiety, I finally got an appointment with a psychiatrist, my mom and I had to drive over two hours each way three times. Even with insurance, we paid hundreds out of pocket for these fifteen minute apiece visits, all to receive a 10mg prescription and vague diagnosis. Three times now, my birth control has been switched to new medications without warning because my insurance ended coverage of the old one. When I broke my wrist in third grade, my dad wrapped it up with an Ace bandage, and we waited three days for the swelling to go down before giving in and visiting the ER. And each time I board a flight to school, I lose medical insurance coverage as soon as I leave the state of Texas.
I grew up with CHIP, the children’s branch of government-sponsored health insurance, and, in a couple of years, I will be transferred to Medicaid. For context, both of my divorced parents are public school workers—my mom teaches music at an elementary school, and my dad is an assistant principal at an intermediate school. Their incomes never pushed us far over the National Poverty Level (NPL), putting my family of six under government health care in Texas. That last part is key: in the current Medicaid system, states partner with the federal government to cover patients. The U.S. government matches state funding to a certain point, and then gives each state large control over how to allocate these matched funds. For me, this means that, while I slip just under the line and receive CHIP coverage in Texas (where kids my age are generally covered up to 133% of the NPL), if I had lived here in New Hampshire I would have been covered even if our income was 318% of the NPL.
The healthcare system is already a mess, and, even with my current coverage, my mom makes countless phone calls every month trying to negotiate coverage for me and my siblings. Just this year, CHIP denied us dental funding and forced me to wait until at least November to get my painful wisdom teeth removed. If Trump wins the 2020 election, he has promised to place new caps on Medicaid, which would cut how much the federal government will match the state’s money to begin with. Worse still, he also wants to switch to a system of block grants, which would give states a set amount of money each year with few guidelines on how they spend it.
States like mine would be even more likely to play fast and loose with the rules under Trump’s plan. Joe Biden’s plan is not Medicare for All. He is not Bernie Sanders, and many of us are disappointed by that. He does, however, want to remove the cap on federal matches and make it so that no family spends more than 8.5% of their income on premiums.
We all have our reasons to care about this election, but I beg you not to forget Medicaid, Medicare and CHIP. There are millions of people like me who already have to fight for care, are at risk of long term illness due to financial insecurity and cannot handle more cuts and restrictions.