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Medicaid is a joint federal and state program that helps with medical costs for some individuals with limited income, disabilities or need for long-term care. Medicaid provides health coverage to millions of Americans, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities. Medicaid is administered by states, according to federal requirements, and responsibility for funding the program is shared between states and the federal government.
More than 30 million children nationwide rely on Medicaid for health insurance coverage. Many are families with low incomes who do not have access to or cannot afford commercial insurance for their children. Others are covered by commercial insurance but have serious, chronic medical conditions that require regular and ongoing therapies and specialized care covered by Medicaid.
Medicaid is the single most important healthcare program for children in America, and we believe indiscriminate cuts to Medicaid will hurt children disproportionately. Children are already the lowest funded population group in the federal budget. As Congress considers the future of Medicaid, any potential reforms must protect the unique needs of children.
Further, cuts to Medicaid by lawmakers in Washington D.C. will simply shift the costs from the federal government to states, providers, families and patients. In particular, so-called “block grants” or “per capita caps” would put state budgets at risk if Medicaid costs go up—as happens during recessions or natural disasters. This would make it hard for states to deal with competing priorities like education or transportation.
Half of the nation’s children, some 36 million, are provided healthcare through the Medicaid (30 million) and CHIP (6 million) programs. Our country needs these children to grow up to become the healthy adults who will drive our future economy, workforce, security and communities.
Of the 74 million beneficiaries in the Medicaid and CHIP programs, nearly 50% are age 0-18. Current proposals to reduce federal spending in Medicaid would cut support for children’s healthcare, putting their health at risk.
Children are the lowest funded population in Medicaid and in the federal budget as a whole. Children account for nearly half of Medicaid enrollees, but only about 20% of the costs.
Medicaid is an investment in our nation’s security and our future, covering the children who will grow to be the next generations of our nation’s business, community and military leadership. Compared to the uninsured, children on Medicaid are healthier and go on to achieve higher educational and economic outcomes as they become adults.
Medicaid provides for essential elements that must be protected and strengthened, including pediatric-specific benefits. Ensuring kids have access to the care they need is the right thing to do, but it’s also a wise and necessary investment in our future as a nation.
Children covered by Medicaid benefit from essential program elements designed specifically for them. We believe that the following need to be maintained and strengthened in the upcoming healthcare debates:
We have made progress on children’s health through investments in programs like Medicaid and CHIP that have shown better health and educational outcomes for children and the country as a whole, relative to children who lack health insurance. But we need to do better. Mental health coverage and benefits, in particular, are lacking.
Children need continued support to ensure they have coverage that meets their needs and receive necessary care. Strengthening support for children in their early years will improve the future lives of all children in the program, and as a nation, ensure we stand behind the sickest children and their families.
The Early and Periodic Screening, Diagnostic and Treatment (EPSDT) is a required benefit for children under Medicaid. Simply put, it means that children can get care that is deemed medically necessary by a physician. EPSDT ensures coverage of well-child care and immunizations, along with periodic screenings and needed treatments. This minimum federal standard is necessary so that states facing budget shortages don’t balance their books by cutting these essential services for children.
As Congress considers any Medicaid reforms, we must protect the unique needs of children under any policy concept. We have serious concerns that fundamental changes to the financing of Medicaid—such as capping or limiting federal support, or removing proven benefit concepts such as EPSDT—could unintentionally jeopardize kids’ coverage, benefits or access to care.
Like any program, Medicaid has room for improvements, and we are actively supporting one proposal in Congress to improve Medicaid for the kids who need it most. But we do not support arbitrary cuts in federal spending that push costs to the states without the elements essential to advancing children’s healthcare.