Old male doctor examining a child patient by stethoscope. Health care concept.

What’s at stake for children’s health care?

A few weeks after Jessica Jayne learned she was pregnant, she lost her job.

It was spring 2012 and she and her husband, Tyler Jayne, lived in Eugene, Oregon, where she had been managing a secondhand retail store and he served as a part-time social worker. Her job provided benefits; his did not.

“We were terrified,” Tyler Jayne, 33, said.

After their son was born in January 2013, the Jaynes enrolled in the Oregon Health Plan, the state’s Medicaid program. Doctors diagnosed their son with jaundice, which required nearly two weeks in the hospital and a light bed. The medical coverage they received under the Affordable Care Act, also known as Obamacare, was crucial, he said.

“If we got a bill from the hospital for the extended stay, it would have bankrupted us,” Tyler Jayne said, adding that his 4-year-old son and 1-year-old daughter remained under the state health plan.

For months, the Trump administration and Congress have debated the future of health care, including nearly $1 trillion in cuts to Medicaid, which has enrolled nearly 37 million children. By comparison, 8.4 million children have been enrolled in the Children’s Health Insurance Program and its funding is up for reauthorization in September.

With Medicaid’s future in question, Tyler Jayne is concerned that he and his wife will have to forgo their own health care in order to cover their children. Their household income simply can’t cover insurance for everyone in the family.

By 2015, five percent of U.S. children lacked health insurance, an historic low, according to the Annie E. Casey Foundation, which attributed near-universal children’s health coverage to the Affordable Care Act, Medicaid expansion and the Children’s Health Insurance Program. That’s down from two decades earlier when 15 percent of U.S. children were uninsured.

Each year, the foundation measures children’s well-being in the U.S. using a composite score that reflects 16 indicators for family and community, economic, health and education. In 2015, the latest data available, New Hampshire, Massachusetts and Vermont were the three highest-ranking states overall for children’s well-being, while Louisiana, New Mexico and Mississippi ranked lowest.

To better understand children’s health care, researchers analyzed four health-related indicators: low birth weight, uninsured children, the death rate for children and teens per 100,000 deaths, and teen consumption of alcohol or drugs.

In fact, health care was where the foundation’s researchers found the biggest gains in child well-being, said Florence Gutierrez, who develops and manages the Kids Count database.

Medicaid, Obamacare and the Children’s Health Insurance Program (CHIP) “have helped ensure that children have access to health care services,” Gutierrez said. “We believe these are health care programs that are working and that should be supported moving forward.”

Joan Alker directs Georgetown University’s Center for Children and Families, which released an October report with similar findings, and said improved access to health insurance for more children is a “national success story,” but cautioned that “it’s very much at risk.”

With millions of children benefiting from Medicaid, Alker said, children “can’t run and hide.”

On May 4, the House approved a GOP overhaul the Affordable Care Act. When asked about the futures of CHIP or Medicaid, Republican Sen. Mitch McConnell’s office said the Senate majority leader has been a long-time supporter of CHIP in particular, adding that the program was separate from the health care bill currently under discussion.

“He voted for SCHIP’s creation and introduced bills in the past to extend the program,” McConnell’s press secretary, Stephanie Penn, said in a statement to the NewsHour.

Penn did not specifically address concerns from children’s advocates over Medicaid. The Congressional Budget Office last month said the House’s health care overhaul plan would leave 51 million Americans without health insurance by 2026. If the ACA remained unchanged, 28 million Americans would be uninsured in the same time period, the budget office said.