Why is 'Obamacare' Picking on Military?


A home visit program tied to the Affordable Care Act, or "Obamacare," could result in forced home visits by state officials both on and off base for active duty and former military members with young children, according to a rumor circulating conservative online publications.

The Maternal, Infant and Early Childhood Home Visiting Program was established as part of the Affordable Care Act. Through it states receive grants from the Health and Human Services Department (HHS) to establish or expand per-existing state run home visitation program. The program aims to focus on "high-risk" families including current and former members of the Armed Forces and, specifically  "such families that have members of the Armed Forces who have had multiple deployments outside of the United States."

It's pretty clear that the rumor that the visits will be "forced" is unfounded. PoliticFact, which fact checks rumors like this one, gave it  a "pants on fire" ruling. According to their research, the law makes it painfully clear that participation in the program is to be "voluntary." No one is going to be busting down your door, according to their investigation.

But what they don't answer is the question of why the authors of this portion of the health care legislation decided military families are one of their eight "at-risk" categories. The other at-risk categories are:

- Low-income families

- Pregnant women under 21

- Those with a history of child abuse or neglect or "interactions" with child services

- Those with a history of substance abuse or in need of treatment

- Those who use tobacco products in their home.

- Those with kids with low student achievement

- Those with kids with developmental delays or disabilities.

Take a look at that list.

What I see is a run-down of behavior descriptions -- not job descriptions. You don't see "those with a family member who is a lumberjack" on the list or "families where one member travels constantly for business."

The inclusion of "military families" on the at-risk list makes it the only group singled out by HSS because of a profession.  It lumps together all military families -- married, single-parents, young, old, new, experienced, blended families.  It assumes that the families of servicemembers who have just come home from actual combat in a war zone are the same as those who have worked in an office building in Nevada for five years or deployed three times on a ballistic submarine.

In the military? Deployed more than once? Then you must be in the riskiest possible career for your children, right?

That simply isn't true.

Now, I'm not saying that military families can't use help. People from every walk of life can use the assistance of a friendly early childhood expert who is offering you kind suggestions on dealing with a difficult child from the comfort of your own home. Frankly, had such a helper knocked on my door when I was having a darn hard time learning to breastfeed my child I would've let her right in.

And sure, there are plenty of studies that show that military youth are more at risk for psychological issues than their civilian counterparts.

But the youth -- school-aged kids -- those studies are focused on won't be helped by this program. This is a program for the little guy set, those years when your kid needs diaper changes and puts his jam hands all over your sofa.

What the authors of this program missed when they labeled all military families as being "at-risk" is the research that shows that  that the children of deployed servicemembers follow the example of the caregiver.  If the caregiver handles the deployment, the children handle the deployment.

Yes, if the at home parent is a depressed, low income, known child neglecter, then the kids are likely to be unwell or have behavior problems.  But won't those families be picked up in the previously mentioned categories?

Health and Human Services seems to be ignoring multiple studies that report military children have been shown to typically function as well as or even better than civilian children. They have similar or lower rates of childhood psychopathology, lower rates of juvenile delinquency, lower likelihood of alcohol or drug abuse, better grades, and higher median IQs than their civilian counterparts.

Difficult life events do not automatically lead to problems in children. Most of these studies about military kids focus on the families during a lengthy deployment when the family is under the most stress.  In what way does that qualify folks for an at home visit when deployment is no longer a part of their lives -- or result in them being singled out for the "risk" list?

We well know that some military families are troubled. You may remember the story of 22-month-old Tamryn Klapheke who died of malnutrition and dehydration when her mother, 21-year-old Air Force Spouse Tiffany Klapheke put her in her crib and ignored her cries. Tamryn's father was deployed. After her arrest Tiffany complained that “nobody took a second to ask me if there was anything they could do to help or if I needed anything and I wish they would have."

Tiffany, who said she was depressed and had at least once previously discussed committing suicide, could have used the helper-person knock on her door.  Let's make sure the Tiffanys get the help they need.

Let's think again about what it means to identify all military families as offering their children a life of risk so great that the government must automatically intervene.  Surely that implies something bigger, more troubling and disruptive than what the situation requires.

Jacey Eckhart contributed to this post.

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