Medicaid’s Role for Kids and Children’s Hospitals

Medicaid’s Role for Kids and Children’s Hospitals

Medicaid ensures access to care for millions of children and is critical to sustaining pediatric care.

Medicaid provides essential health coverage for an estimated 35 million children in the United States. It is also an important source of coverage for children with complex medical conditions.

Millions of children covered by Medicaid are able to access a comprehensive set of medically necessary services through the early and periodic screening, diagnostic, and treatment (EPSDT) benefit. In addition, Medicaid also plays a critical role in children’s behavioral health as the nation’s largest payer for behavioral health services.

Children’s hospitals rely heavily on Medicaid to continue providing critical pediatric care. On average, Medicaid provides health insurance coverage for half of children’s hospitals patients and for some children’s hospitals patient mix, closer to three-quarters.

Because Medicaid rates are historically lower than both Medicare and commercial rates, it is crucial that additional investments are made in the Medicaid program to ensure that children maintain access to care.


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