Medicaid and Children with Special Health Care Needs
Medicaid-related Resources from the Catalyst Center
The Catalyst Center has created resources to help better understand the role that Medicaid, and health insurance in general, play in supporting the health and well-being of children with special health care needs and their families. The two public health insurance programs—Medicaid and the Children’s Health Insurance Program (CHIP)—provide an important source of coverage for children with special health care needs, as illustrated in the chart below:
Forty-four percent of children and youth with special health care needs
rely on public coverage—Medicaid and CHIP (Children’s Health Insurance Program)—
as either primary or secondary coverage for their health care needs
Source: National Survey of Children with Special Health Care Needs. NS-CSHCN 2009/10. Data query from the Child and Adolescent Health Measurement Initiative, Data Resource Center for Child and Adolescent Health website. Retrieved May 8, 2012 from http://www.childhealthdata.org
- Fact Sheet: Medicaid and Children with Special Health Care Needs/Disabilities: An Overview. Learn the basics of how Medicaid is funded and administered, children’s eligibility and benefits, state-to-state differences, optional pathways to Medicaid for children with disabilities, and additional resources that provide a more in-depth understanding.
- Fact Sheet: The Children’s Health Insurance Program (CHIP) and Children with Special Health Care Needs: An Overview. Learn the basics of CHIP funding, administration, benefits, children’s eligibility and state-to-state differences.
- Medicaid & CHIP: What’s the Difference? An infographic that provides an at-a-glance comparison of Medicaid and CHIP and the difference it makes for children with special health care needs.
- Public Insurance Programs and Children with Special Health Care Needs: A Tutorial on the Basics of Medicaid and The Children’s Health Insurance Program (CHIP) provides a user-friendly overview of Medicaid and CHIP coverage for children and youth with special health care needs (CYSHCN), specially written with Title V MCH staff and family leaders in mind. It includes information on how Title V and state Medicaid officials can work together to increase the quality and decrease the costs of health care for children with special health care needs.
- Webinar series based on above Medicaid and CHIP tutorial
- Medicaid as a Second Language: A Slightly Irreverent Guide to Medicaid Terms, Acronyms and Abbreviations helps to demystify the language of Medicaid for policymakers, advocates, legislators, consumers, family members, and providers interested in financing care for children and youth with special health care needs at the state level through the Medicaid program.
- Your Questions About the Medicaid Expansion Provision of the Affordable Care Act Answered
- Medicaid Matters for Kids: What We Told Them A briefing for congressional staff by representatives from several organizations, including the Catalyst Center
- Why Health Insurance is Important to Children and Youth with Special Health Care Needs provides a brief overview of the scope of the problem of inadequate insurance and the financial hardship it causes for the families of these children.
- Breaking the Link puts a human face on the problem by describing the situation of three families of children with special health care needs. Medicaid plays a role in two of these stories. The booklet outlines how a child’s special health care needs can lead to financial hardship for the family through higher health care costs, higher routine expenses and loss of employment income and describes programs that can help support these families.
- States Seek Alternatives to Medicaid Spending When Families of CYSHCN Can Least Afford Them While access to Medicaid in difficult economic times is important to CYSHCN and their families, it presents serious challenges to states.
- Medicaid and CHIP Buy In Could Help Children Excluded from Private Market, a guest posting on Say Ahhh! the Georgetown University Center for Children and Families health policy blog
- Medicaid Buy in programs: With the passage of the Family Opportunity Act (FOA) in 2006, Medicaid buy-in programs for children with disabilities are being implemented in a handful of states. The FOA allows states to expand eligibility to children under age 19 who meet the functional disability criteria for Supplemental Security Income (SSI) and whose families’ adjusted gross income is less than 300% of the Federal Poverty Level (FPL). Premiums are often charged on a sliding fee scale and there are co-pays. These programs are particularly important for underinsured CYSCHN because they allow families to purchase Medicaid benefits specifically to cover services that are not covered or are covered inadequately by employer-sponsored insurance plans. The Catalyst Center has created a series of resources related to these programs. They can be accessed through the Medicaid Buy-in overview page.
- The Patient Protection and Affordable Care Act (ACA): Medicaid is an important element of the ACA. The Catalyst Center has created several resources related to the ACA; they can be accessed through our ACA overview page.
- What’s the Deal with MOE? [PDF] States want to cut Medicaid spending. Are CYSHCN at risk? The Maintenance of Effort (MOE) provisions in the Affordable Care Act have come under scrutiny by some states under stress due to fiscal constraints. This article discusses how the MOE provision and changes to it may affect children and youth with special health care needs.
Additional Resource:
The Georgetown University Center for Children and Families and Family Voices published an issue brief that presents common themes on the importance of Medicaid coverage for children and youth with special health care needs (CYSHCN) which were identified in interviews with 20 families. The report outlines specific policy implications for CYSHCN and their families: Medicaid and its Role for children and Youth with Special Health Care needs (CYSHCN): A Family Perspective.
