Let’s Not Abandon the Children Who Need Us Most
As Vice President of Strategy at a not-for-profit hospice and palliative care organization in North Carolina with a growing pediatric program, I witness daily the profound impact Medicaid has on the lives of seriously ill children and their families. Over half of the children in our care rely on Medicaid to access the complex, compassionate services they need. These aren’t just numbers on a spreadsheet. These are infants with congenital conditions, toddlers battling cancer, and teens navigating progressive and debilitating neurological diseases. They are children whose lives depend on the continuity of care, and families whose financial realities leave little room for uncertainty. And they rely on Medicaid not just for doctors and hospitals, but for the feeding tubes, in-home nurses, therapies, and medications that help them survive.
When private insurance doesn’t come through–Medicaid steps in. For the families we serve, almost half of whom earn less than $60,000 annually and live in households of four or more, Medicaid isn’t a backup plan. It’s the only plan.
But that foundation is being shaken.
With proposed federal cuts to Medicaid on the horizon, the consequences are already surfacing. States will be forced to narrow eligibility, reduce the scope of covered services, and lower reimbursement rates–decisions that directly harm children.
The Children’s Hospital Association estimates these policies could slash $114 billion in funding for children’s health care over the next decade. Meanwhile, Georgetown’s Center for Children and Families warns that pregnant women, infants, and disabled children will shoulder the brunt of these cuts. This isn’t just bad policy. It’s a failure to protect those who can’t advocate for themselves.
We’re already seeing the ripple effect. Families are worried they’ll lose home nursing, medication, and basic nutrition for their families. Care teams are bracing for fewer approved treatments and a decrease in reimbursements. And kids are caught in the crosshairs.
There’s no gentle way to say this: cutting Medicaid is a moral failure.
It’s also shortsighted.
Medicaid gives families the ability to care for their children at home, in loving environments. It funds the therapies offered in schools, postpartum support for new mothers, and early interventions that can change the course of a child’s life. These aren’t luxuries. They’re lifelines.
Cutting Medicaid won’t just save money— it will push vulnerable families into crisis, send children back into hospitals unnecessarily, and deepen the divide between those with access and those without. We can’t ask families who are already stretched thin to bear this burden.
I urge lawmakers to consider the real-world consequences of these decisions. Look at the data, but also look into the eyes of the children who will suffer.
These are real families – parents who have become nurses overnight, siblings who grow up too fast, and children fighting for every birthday.
Medicaid isn’t a line item—it’s a promise. Let’s not break it.
Mary Lucas is a Raleigh native who serves as the vice president of marketing at Transitions LifeCare, a local hospice and palliative care nonprofit organization. She also serves on the Orange County Animal Services Advisory Board and the Advisory Board on Aging.