Patricia Murphy: Medicaid cuts from Washington would gut this Georgia pediatrician’s practice

To get a sense of what cuts to the program could mean for children in Georgia, I visited Dr. Dorsey Norwood earlier this week. Norwood is a pediatrician who I‘ve known since we went to kindergarten together in Atlanta. Even in elementary school, she was the smartest kid in class. After medical school, she worked briefly at her father’s pediatric practice in Buckhead, and then left to work in South Atlanta.

Norwood now runs her own pediatric practice on Cleveland Avenue near East Point, complete with a bright and cheery waiting room to welcome patients and their parents. But you don’t need to look further than the shuttered South Fulton Medical Center next door to understand that this is the part of the city that most doctors and hospitals abandoned long ago, leaving vast swathes of Georgians without accessible, reliable health care in the process.

Norwood is an exception.

Not only has she stayed in South Atlanta, she has stayed so long that she’s treated multiple generations of several families. She also sees children with complex medical conditions whom other practices sent away, as well as about one patient per week affected by gun violence.

She believes she’s needed where she is, and she’s right.

“I feel like I’m making connections and making an impact,” she said. Although she describes the area as proud and deeply rooted, it also includes pockets of poverty, violence and trauma.

“I’ve had kids in foster care who I knew when they were with their moms, then I knew them in foster care and now I know their adoptive parents,” she said. “I can be that constant for them.”

Even in this working-class section of Atlanta, she estimates that 85% of her pediatric patients are covered by Medicaid, while the rest are mostly covered by their parents’ private insurance plans. That means even a modest cut to Medicaid benefits would be impossible for her practice to absorb.

“As it is, we are just making ends meet,” she said. “A 15% cut? I don’t think I’d be able to keep the business.”

On the morning I visited, Norwood had already seen a newborn baby whose mother had been her patient, as well as a little girl with a chronic kidney condition. A little boy tested positive for COVID, while a prescription for ADHD medication was waiting to be renewed. Next, it was time for Kinsley Wilson’s 9-month checkup.

Kinsley’s mom, Shakira Wilson, has two teenagers who are also patients at the practice. She works full time at Walmart. Although she gets health insurance through her job, covering her children through her private plan would be so expensive she could not also afford rent and groceries. Because her income also qualifies her for Medicaid in Georgia, she is able to make sure her children are insured through the government program.

Like all recipients, she is required to confirm her eligibility through the state of Georgia once a year. But if her Medicaid benefits are cut in the future, she said, “I don’t know how my children would see the doctor.”

“She’s growing like a weed!” Norwood said of Kinsley as the appointment began. “How is she eating?” Shakira said she thinks the baby could have an ear infection, since she’s been pulling at her ears lately. But after an exam that shows everything’s healthy, Norwood explained the child is likely teething and pulling her ears to relieve the pain.

Other than that, Kinsley’s visit is uneventful and one of the many regular checkups she’s able to get for vaccines, height and weight checks, and other markers for a healthy, growing baby.

“See you next time, baby girl!” Norwood called out at the end.

Like Wilson, Norwood said nearly all of her patients’ parents work in full-time jobs, many at companies that provide limited or no health insurance. “Who doesn’t work? They all do,” she said. “These are hardworking people.”

Republicans have been quick to point out that the budget they just voted for never mentions the word “Medicaid” in the text. But the fine print makes it clear that the committee tasked with finding more than $880 billion in spending cuts is the same one that oversees Medicare and Medicaid. Avoiding Medicaid cuts, while also cutting nearly $1 billion from health care programs, will be nearly impossible.

Before members of Congress decide what exactly to cut, including Medicaid, they should acknowledge the effects of the cuts they’re making on the constituents they represent. For at least one Georgia pediatrician, cutting Medicaid benefits for her young patients would leave a wound in her practice that even she couldn’t heal.