Common Policy Priorities for Children's Health
Medicaid is a federal-state program that covers 40 percent all children in the U.S. While a quarter of the population, children are roughly half of all Medicaid recipients. Children’s hospitals provide about 45 percent of the hospital care required by children covered by Medicaid and almost all the hospital care for Medicaid-covered children with complex medical conditions.
Medicaid, on average, pays for 56 percent of all inpatient days of care provided by independent children’s hospitals. However, Medicaid payments for services are inadequate, resulting in barriers to care for children covered by Medicaid. On average, Medicaid pays only 78 percent of the cost of care, even after hospitals account for supplemental payments, such as disproportionate share hospital payments, that provide financial help to hospitals that treat a large number of Medicaid and uninsured patients.
Get the facts on Medicaid in your state by visiting www.childrenshospitals.net/statebystate.
The Children’s Health Insurance Program (CHIP) provides health insurance to children who do not qualify for Medicaid and do not have access to private health insurance. It provides federal matching funds for states that put up funds of their own to expand Medicaid to uninsured children of low-income families, create alternative insurance programs for them or both.
The Affordable Care Act authorizes and funds CHIP through Sept. 30, 2015. After that date, states may enroll CHIP-eligible children in qualified health plans that have been certified by the Secretary of Health and Human Services. Beginning on Oct. 1, 2015, states will receive a 23 percentage point increase in their CHIP federal matching rate. Congress will revisit CHIP, as the program’s funding and authority will need to be extended beyond 2015, providing another opportunity for children’s hospitals and Congress to ensure public policies strengthen children’s health care coverage.
Children’s Hospitals Graduate Medical Education or CHGME
Children’s Hospitals Graduate Medical Education (CHGME) program was created in 1999 to provide children’s hospitals with federal graduate medical education (GME) support comparable to the GME support the federal government provides to adult teaching hospitals through Medicare. CHGME supports the training of 6,000 residents at nearly 60 independent children’s teaching hospitals. Hospitals receiving CHGME funds train nearly half of all pediatricians and pediatric specialists
TRICARE is the Department of Defense military health system for active duty military, guard and reservists, and their families, serving more than 9.6 million beneficiaries, including almost 2 million children. TRICARE is the only health insurance plan for children that is consistent in policy and payment across all 50 states. The Children’s Hospital Association TRICARE Project seeks to optimize the military health system’s understanding of children’s health care needs, and the ability of children’s hospitals to best serve military children.
Additional Resources for Children's Hospital Advocates to Stay Informed
The Children’s Hospital Association website provides more details on policies affecting children’s health and how you can get involved as a champion for children’s health -www.childrenshospitals.net
Take action and find bills, voting records and other legislative activity at our Legislative Action Center at www.capwiz.com/nach.
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Relevant Congressional Committees
House Energy and Commerce Committee
Maintains principal responsibility for legislative oversight of drug safety, Medicaid, and the Children’s Health Insurance Program (CHIP).
Senate Finance Committee
Has jurisdiction over Medicaid.
Senate Health, Education, Labor and Pensions (HELP) Committee
Handles most issues relating to public health, medical research, and individuals with disabilities.
U.S. House of Representatives: www.house.gov
U.S. Senate: www.senate.gov