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The Impact of the American Health Care Act on Children’s Hospitals: Preparing for the Road Ahead

The Impact of the American Health Care Act on Children’s Hospitals: Preparing for the Road Ahead


Throughout his campaign and early administration, President Trump has promised to repeal “Obamacare.” Now, 105 days into his term, he is one step closer to dismantling the Affordable Care Act (ACA) with the passage of the American Health Care Act (AHCA) by the House last week. While there are still many unknowns for the next wave of healthcare reform, decreased funding for Medicaid will be a core component. To date, little discussion has occurred about the impact of the potential spending cuts and programmatic changes on pediatric care.

The underlying premise of the reductions would be to roll back Medicaid expansion and reduce spending on newly insured adults who previously did not have insurance – without any specific eligibility implications for children. However, the sheer magnitude of expected funding cuts, coupled with the shift in responsibility to states that will exhibit variability in how they respond, increase the likelihood of consequences for children who need care. For children’s hospitals, who disproportionately serve children in need of care, there are a handful of options for how to react to the likely changes ahead.

In this paper, we discuss the implications of the AHCA on children’s hospitals and what they can do to prepare for the road ahead.