Children With Medical Complexity
There are 2 million children with complex medical conditions in the U.S. They account for 6 percent of children on Medicaid and 40 percent of Medicaid costs. Under Medicaid, families of children with medical complexity struggle to coordinate their complex, multi-state care. Children’s hospitals are advancing federal Medicaid legislation to ease these burdens, improve care and reduce costs by organizing coordinated networks of providers focused on children with medical complexity.
Children's Health Insurance Program
More than 40 percent of the nation’s children depend on health coverage from Medicaid and CHIP. CHIP is a bipartisan, state-tailored program that provides health insurance for millions of children each year. If Congress does not extend federal funding for CHIP, it will begin to expire Oct. 1, 2015.
Medicaid is the single largest health insurer for children – providing a comprehensive set of benefits to more than 40 percent of children nationwide and the majority of children with complex medical conditions. Children’s hospitals are major Medicaid providers, and the program is the largest payer of patient care in children’s hospitals.
Graduate Medical Education
Children’s access to care depends on an adequate number of pediatric specialists and subspecialists. The Children’s Hospitals Graduate Medical Education (CHGME) program provides federal funding to freestanding children’s hospitals to support the training of pediatricians and other residents. The future of our pediatric workforce hinges on continuous and adequate funding of this successful program.
Children’s hospitals strengthen their communities by serving as advocates for children’s health and well being. The Association supports the leadership of children's hospitals and promotes their involvement in public education, community health and the advancement of child health policy and legislation.
Private Coverage & Exchanges
The Affordable Care Act requires states to have an Exchange for individuals and small employers to obtain private and public health insurance. It also creates premium tax credits to make private insurance affordable, requires most health plans to cover a minimum package of “essential health benefits” and prohibits pre-existing condition exclusions and other limits on coverage. An estimated 1.9 to 4.3 million children will purchase private coverage through an Exchange by 2019.
Access to life-saving specialized medicines is critical for many children. Children’s hospitals depend on the ability to obtain pharmaceuticals in various ways, which includes participation in the federal 340B Drug Discount Program and the usage of group purchasing organizations.
Children’s hospitals may access tools and legal guidance to build and strengthen their issue advocacy capacity, as well as engage their communities on behalf of children before the local, state and federal legislatures.
Speak Now for Kids Campaign
Speak Now for Kids is the Association's online advoacy network designed to help raise awareness of the unique challenges which children and families face in our changing health care system.