States facing sudden drops in tax revenue amid the pandemic are announcing deep cuts to their Medicaid programs just as millions of newly jobless Americans are surging onto the rolls.

Children could be disproportionately affected, because the percentage of Medicaid spending that states have to bear for adults is much lower, according to health economics experts at Rice University.

Richard Boylan, professor of economics, and Vivian Ho, the chair in health economics at Rice's Baker Institute for Public Policy and a professor of economics, studied the issue in their 2017 paper, "The Most Unkindest Cut of All? State Spending on Health, Education and Welfare During Recessions." They found state spending cuts during economic downturns fall more heavily on children than the elderly. The scholars are available to discuss their insights with the news media.

"The negative revenue swings we mentioned in that paper will be much steeper in this downturn," said Ho, who is also a professor at Baylor College of Medicine. "We found that that the cuts to Medicaid fell mostly on children. However, our previous analysis did not include data from after the Obamacare Medicaid expansion to adults in many states. Nevertheless, children could still be disproportionately affected, because the percentage of Medicaid spending that states have to bear for adults is much lower, namely 10%."

In discussing the 2017 paper, Ho said, "We became interested in studying the effects of economic downturns on public spending during the Great Recession of the late 2000s, when media outlets were filled with stories about states cutting optional Medicaid benefits, increasing school class sizes and reducing course offerings. More broadly, there is growing political sentiment that government spending should be slashed in order to reduce waste in the system."

The researchers' analysis indicates that on average, states suffered a $222 per capita negative revenue swing in 2009, which in the long term led to a $64 cut in Medicaid spending per child beneficiary, a 1% reduction in the number of elderly people enrolled in Medicaid and an $82 per capita cut in long-run state education spending.

"The combined cuts to Medicaid and education measured in our study suggest that spending cuts during economic downturns fall more heavily on children than the elderly," Boylan said. "The Medicaid cuts are sobering, given that other economists have found that Medicaid coverage is effective in reducing infant and child mortality."