HISTORIC RATE OF INSURANCE FOR CHILDREN
PUBLIC COVERAGE FOR CHILDREN
THE BENEFITS OF MEDICAID
• Medicaid helps children grow up to reach their full potential.
Children enrolled in Medicaid:
• Medicaid has also contributed to declines in infants and child mortality
THE COST OF CHILDREN IN MEDICAID
CONCERNS WITH NEW FUNDING PROPOSALS
Block grants or per capita caps will:
• Shifts costs to states
• Not automatically increase federal funding during economic
downturns or public health crises
• Mean that states won’t be able to make up shortfalls
• Could result in:
– Decreased eligibility levels
– Loss of EPSDT
– Wait lists
– Increased cost-sharing for families
– Work requirements
– Winners and losers amongst
current Medicaid populations
WHY CHIP IS NOT A MODEL FOR MEDICAID
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70 million (Medicaid) vs. 8 million (CHIP)
States get more matching funds for CHIP than Medicaid
CHIP is not an entitlement and not permanent
The goal of a Medicaid block grant is to reduce
spending—not to improve or expand coverage
HOW AAP EVALUATES COVERAGE PROPOSALS
AAP Endorsed Principles on Access
• Every child should receive care in a medical home with a primary
care pediatrician and access to pediatric subspecialists.
• Quality health care is a right, regardless of income, for all children,
their families, pregnant women, and ultimately all individuals.
• Every child must have quality health insurance.
• Plans should have a comprehensive age appropriate benefits.
• Payment rates should assure that children receive all needed services.
So… Two Key Questions for Every Proposal
1. Does every child maintain access to coverage (entitlement)?
2. Does every child maintain access to medically necessary care
(EPSDT)?