Five days a week, Michaela Randle, 27, prepares her two daughters for school and then picks them up from her mother’s care after work while juggling her many other parental obligations. She executes these responsibilities, however, with an exhausting cloud of anxiety hanging over her: Her oldest daughter, 8, does not have health insurance.
Every day, as her oldest daughter runs headlong into life, she unknowingly navigates a world where her mother cannot afford for her to break a bone, contract a virus or need a surgery — realities common to the lives of children.
Michaela is my younger sister, and her daughters are my nieces. While Michaela knows, in the event of a moderately expensive medical tab, she can depend on our family for financial support, millions of other parents lack a built-in familial safety net.
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My nieces’ health care vulnerabilities and my faith-rooted activism in New Jersey drew me to see more clearly the moral lapse of federal and state governments to safeguard children from the multifarious consequences of a rigged economic arrangement — a system that privileges the rich and creates barriers for the majority of Americans.
In the wealthiest nation in the history of the world, something unnervingly duplicitous rings from shore to shore when one unexpected medical emergency eventuates the possibility of homelessness or a chronic illness terminates in bankruptcy.
The US’s Uninsured Children
In a post-Obama US, the number of uninsured children hovers around 5 percent. Most children access affordable health care via the options furnished by the Affordable Care Act (ACA), their parent’s employment benefits, or safety nets like the Children’s Health Insurance Program (CHIP) and Medicaid. The existing insured children’s rate enjoys a laudable height — 95 percent. However, more than 3.6 million children in the US remain without access to quality affordable health care in the event of a physical accident, flu pandemic or treatable genetic disease. One uninsured child is unacceptable in the US. Millions of uninsured children in the US underscore our moral failure as a nation.
Alarmingly, 70,000 uninsured children reside in my home state, New Jersey, alone. According to the New Jersey Policy Perspective, a left-of-center think tank and economic policy advocacy organization founded in 1997, the expansion of Medicaid relative to the ACA reduced the child uninsured rate in the state by one-third since 2013. Even states with lower costs of living and more depressed tax revenue — like Alabama and West Virginia — insure children at a greater rate than New Jersey.
Each time our system denies health care coverage to a child because of immigration status, because her parents’ salaries slightly exceed income limitations or because of administrative barriers, we shoot down hopes for these children’s futures.
In the medical sphere herself, Michaela works as a caregiver at a residential nursing facility for persons living with Alzheimer’s and dementia. “If you don’t tell them about an address change or report your employment status, they just cancel your plan,” she said concerning health insurance providers. “People with jobs need Medicaid because we don’t have extra money to just go to the doctor…. It is just too damn expensive, and kids get sick all the time.”
We strike a disingenuous chord in our health care conversation when we flatten how race and immigration status function in terms of accessing affordable health care. As a result of economic and administrative obstructions, Latinx children, many of whom are undocumented, constitute 42 percent of the national child uninsured rate.
More dreadful still, immigration status, aggressive work requirements and distorted income qualifications foreclose opportunities for millions of families to secure quality affordable care for their children. While Michaela is neither Latinx nor a person with contested immigration status, her children suffer from the very same inconvenient truth that haunts many non-white and non-American lives: US institutions, from health care insurers to the legislatures, see them as disposable, ignorable and terminable.
Our failure to insure all children within our shores makes poverty terminal, stigmatizes certain illnesses and further dispossesses hardworking families. In a nation of opulent consumerism and inequitable distribution of resources, we must ensure poverty, immigration status and non-whiteness do not become death sentences.
The extended waits and relatively scurried care of emergency rooms offer these families their sole, largely uncertain, route to medical care. The features of this medical apartheid deny children the benefits of regularly scheduled checkups, cost-effective medications and comprehensive examinations.
These children remain locked out of the nation’s healing places and economically stunted from preserving their own youthfulness. We dangle health care in the faces of working-class families as if it were a privilege for the fiscally deserving few instead of a human right.
The systematic denial of health care access to children in our republic bolsters this American medical apartheid — the gross racial disparities in health outcomes targeted by the ACA, Medicaid and CHIP.
A moral affliction normalizes the implications of poverty and economically quarantines the most vulnerable from the quality health care they need. Individualism infects our eyes to be the point that we can’t even see the suffering of children, or we fail to care about the pain that we do see.
Insuring the US’s Children
Now is the time for the insured to speak up for uninsured families and children. To protect all of our children, Congress must immediately pass measures that automatically enroll all children born in a US health care institution, and simplify the enrollment and renewal processes. Likewise, a health care program that protects children more than the special interests of insurance companies, discontinues waiting periods and improves termination notification practices.
Ultimately, though, our government needs to guarantee a Medicare for All program — universal single-payer health care coverage — irrespective of immigration status.
When we guarantee health care coverage for all children, we reduce parental anxiety, school absenteeism, financial burdens, and health- and money-related high school dropouts. The healing of our nation hinges on the federal and state governments’ will to protect and expand existing legislation, not cutting it, as President Trump proposed just months after Congress saved CHIP for the next 10 years.
With so much at stake, we must raise our voices, engage our pens and plant our feet in opposition to this horrifying moral apathy toward non-white lives and non-citizen bodies. It is imperative we create access to quality affordable care for all of our children.