Eligibility, Enrollment Potential Barriers to Children Receiving Medicaid After Cuts: Chris Johnson, MBA

Chris Johnson, MBA, CEO and founder of Bluebird Kids Health, spoke about the main effects of the Medicaid cuts associated with pediatric health, introduced in the One Big Beautiful Bill Act, as these cuts could lead to millions losing their health care.

This transcript has been lightly edited for clarity; captions are auto-generated.

Transcript

Can you explain how the Medicaid cuts introduced in the budget bill will present themselves in the coming years?

Yes, I'd be happy to, with the caveat that I've been very focused on the impact to children, given our business. I really view the impact on Medicaid in 3 large buckets. Bucket no. 1 is around eligibility and enrollment. Who is eligible for [Medicaid] and CHIP [Children's Health Insurance Program] when it comes to children, and what are the enrollment processes required. Two are on kind of rate caps. This is where the bill actually provides some guidance around how much states are allowed to pay providers, specifically hospitals in their network. And third is impact on provider taxes, especially in Medicaid expansion states.

When I think about children, the area where there's probably the most direct exposure is around eligibility and enrollment. There are new criteria around what citizenship status you need to have to be eligible for Medicaid and/or CHIP that will likely have an impact on children. It's not a huge impact. It's not like in the millions, even in some of the analysis that you've seen come out from Kaiser, but it's probably somewhere in the 50,000-to-100,000 range over 10 years. An important subset, but not quite as large as some of the bigger numbers that you hear in the broader Medicaid.

Then the other area that I think it's just hard to know how this will fall will be provider taxes. I think it's very unclear how states that are going to have budget shortfalls for funding their overall Medicaid program will have to make changes within that Medicaid program, and will there be areas that it impacts children? Maybe. I don't know. States haven't really explained exactly how they're going to cover for that budget shortfall, and so I think those are some things that we'll have to look at in the coming months and years.

I think that's the other interesting thing about this bill is, a lot of it is the new provisions. Many don't come into effect for 1 to 2 years, and then a lot of the provisions are actually just delays or even repeals of previous legislation that hadn't come into effect yet. There's just some really interesting things, like certain things are being removed, but we actually never had them. We just had them kind of legislatively, but they hadn't been rolled out. I think there's still a lot of uncertainty around how that will play out.