DEC and CEC are concerned that the Medicaid refinancing proposal that the House Energy and Commerce Committee is considering this week jeopardizes health care for the nation’s most vulnerable children: children with disabilities, children in poverty, and infants and toddlers. Specifically, a per capita allotment system for states will undermine state’s ability to provide America’s neediest children access to vital health care that ensures they have adequate educational and developmental opportunities and can contribute to society.
Medicaid is cost-effective and an efficient way to fund essential health care services for children. In fact, while children comprise almost half of Medicaid beneficiaries, less than one in five dollars spent by Medicaid is consumed by children. Accordingly, a per capita allotment, even one that is based on different groups of beneficiaries, will disproportionately harm children’s access to care, including services received at schools and early childhood programs. Considering these unintended consequences, urge your member of Congress to vote “No” on any Medicaid refinancing proposal that undermines health care for children with disabilities.
The Consequences of Medicaid Block Grants or Per Capita Allotments Will Potentially Be Devastating for Children.
Significant reductions to Medicaid spending could have devastating effects on our nation’s children, especially infants and toddlers and those with disabilities. States that opt to take advantage of a block-grant would only have to provide required services to the “most vulnerable elderly and individuals with disabilities” which means they could deny health care coverage to children due to the underfunding of IDEA.
Districts and programs rely on Medicaid reimbursements to ensure children with disabilities have access to services to help ensure a Free Appropriate Public Education (FAPE) and early intervention. Potential consequences of this critical loss of funds include:
Limited or blocked access to early intervention services
Fewer health services
Cuts to general education
Fewer critical supplies
Fewer mental health supports
Noncompliance with IDEA
Medicaid and Part C of IDEA
Currently, Medicaid is a critical source of funding for Part C Early Intervention. While Medicaid is often the payer of last resort for health care, in Part C of IDEA Medicaid (if available to a child) is required to be tapped prior to using IDEA funds. This allows for states to have access to more IDEA funding that could otherwise be diverted to Part C.
Additionally, Early Periodic Screening Diagnostic and Treatment (EPSDT) is a required benefit under Medicaid that requires diagnostics or treatment that is medically necessary to be provided to a child when a routine screen indicates a potential condition. This is important because many Medicaid programs use managed care plans for most aspects of benefits and EPSDT ensures children’s needs will be met regardless of the managed care plan’s limitations.
Further, Medicaid Home and Community-Based Services (HCBS) Waivers for Early Intervention help states to share the costs of Medicaid for those with specific or significant needs. These waivers provide flexibility to states to develop and implement home and community-based services to those who would not otherwise receive Medicaid unless they lived in an institutional setting.
Refinancing Medicaid to be used as block grants or per capita allotments would have an immediate, significant, damaging effect on infants and toddlers that are at-risk or who have disabilities.
Visit the Legislative Action Center to write your Representative and tell them to vote “No” on any Medicaid refinancing proposal that undermines health care for children with disabilities.
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