The New Yorker:

Cuts to federal health-care spending make it harder for doctors to make the oldest promise in medicine: that we will do no harm.

By Rachel Pearson

I am in a hospital room in San Antonio, Texas, and a young mother is begging me—quietly, politely, and in front of her preschooler, whom I’ll call Dani—to make her child well enough to leave the hospital today.

“We’ll do whatever Dani needs,” she says.

“Of course,” I say.

“But could it be today?” she asks.

Her child has a serious infection and is not ready to go home. In fact, Dani may need surgery. The mother only wishes they could leave because Dani is uninsured: every night of hospitalization means thousands of dollars in additional costs.

Dani used to be covered by the Children’s Health Insurance Program, or chip, a program that—similar to Medicaid—provides health coverage to patients who can’t afford it. But a person must reënroll every year or risk losing coverage. During the pandemic, the federal government required states to automatically reënroll people in chip and Medicaid. But the requirement ended in 2023. After that, Texas set about disenrolling poor children from benefits with such cold vigor that the Biden Administration’s Department of Health and Human Services threatened to take action. According to a joint investigation by ProPublica and the Texas Tribune, more than two million Texans, most of them children and most of them eligible for Medicaid or chip, lost their coverage. Some were disenrolled because they filled out forms incorrectly or turned them in late.

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