Sixty-nine percent of enrollees in Medicaid and NC Health Choice—two programs that make up nearly half of the health coverage sources for children in North Carolina—are children. Unfortunately, reckless plans to restructure Medicaid will affect NC Health Choice and put the health and well-being of 1.4 million children across the state at risk.

Last week, lawmakers considered provisions to transform Medicaid into a per capita cap program in the House Committee on Ways and Means and the House Committee on Energy and Commerce. Supporters of Medicaid restructure claim per capita caps will lead to more “state flexibility” and place Medicaid on a budget. However, per capita cap proposals are just another way to repackage cuts to North Carolina’s Medicaid program which will not only hurt the state budget but also the state’s ability to invest in children’s health, well-being, and development.

If Medicaid is restructured into a per capita cap, states will have “flexibility” to cut the number of people covered by Medicaid, the number of services Medicaid provides, or cut provider payments. One critical service they could cut is Early and Periodic, Screening, Diagnostic and Treatment (EPSDT). While the name of the service is vague and even confusing, it is a cornerstone of Medicaid’s capacity to ensure children living in poverty are healthy and are able to reach their full potential.6 While most people agree that no child should live in poverty or be denied health care, EPSDT will be under threat if states share a greater risk for covering the cost of health services covered by this program.