In 1965, President Lydon B. Johnson signed Medicaid into law through the Social Security Act. The program was initially passed to provide medical assistance to dependent children and their mothers, the disabled and the elderly. Today, Medicaid has grown into a program that provides an estimated 35 million children with health insurance coverage.
Medicaid provides children with essential health care services through the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Added to Medicaid two years after its passing, EPSDT ensures Medicaid covers the preventive services all kids need to grow up as healthy as possible. This includes immunizations, well-child checkups, vision and dental services, and treatment for illnesses and disabilities.
Medicaid also covers behavioral health services for children and is the nation’s largest payer for services. In addition, EPSDT covers medically necessary care, so children can see a pediatric specialist or get the therapy they need. From dental cleanings to life-saving vaccines, Medicaid provides children with coverage for the health care they need early on in life.
For the nation’s sickest children, Medicaid is a lifeline. Medicaid covers the 6 million children with complex medical conditions and covers one in three children who are diagnosed with cancer. Many of these children with complex medical conditions are treated at children’s hospitals, which rely on Medicaid to support the lifesaving care they provide to these children.
Children’s hospitals are major Medicaid providers, with Medicaid providing health insurance coverage for half of children’s hospital patients—and for some children’s hospitals, closer to three-quarters.
Although Medicaid pays for many of the services that these hospitals provide, rates are significantly lower than those of both Medicare and commercial insurance. This is causing children’s hospitals to face payment losses. Additional funding is necessary to give children’s hospitals the support they need to continue providing important pediatric care to millions of children across the country.
Medicaid continues to evolve, with states expanding their programs to cover more children and more services. Additions to state Medicaid programs include providing continuous coverage for children up to age six and expanding mental health services for children. States have also started to include coverage to address social issues that affect a child’s health outcomes, including housing and food support for children and their families.
As the Medicaid program continues to expand, covering more children and more health care services, additional support needs to be added to the program to make it as robust as possible. This is especially important for mental health care, as more children are in need of services as a result of the ongoing youth mental health crisis.
Improving Medicaid to ensure real access to care is critical and aligns with the mission of the program—to keep children healthy. The Medicaid program is a strong foundation that we can build on to ensure the best health care for our nation’s children.
Since its inception, Medicaid has provided essential health coverage to millions of children, from every state and background. CHA continues to celebrate Medicaid and all that it does for millions of children in the United States. Happy 58th birthday Medicaid, and to many more years!
