Medicaid and CHIP are essential to children’s healthcare in the United States. It is critical that we continue to fund both of these programs to ensure that our nation’s children continue to receive well child care from their primary care provider. Well child care includes routine visits for vaccinations, ongoing surveillance visits for chronic health conditions, or yearly “check-ups.”
Medicaid was created to assist low-income families in obtaining health care services, whereas CHIP was created to close the insurance gap between low income families and slightly higher income families who did not qualify for health insurance under Medicaid eligibility requirements. Since its inception in 1997, CHIP has provided increased access to care for children, reducing the rate of uninsured children from greater than 12% to just over 7%. Approximately 40% of our nation’s children depend on Medicaid and CHIP as their health insurance.
Historically, Medicaid reimbursement rates have been less than that of Medicare, making it difficult for our primary care providers to provide adequate care to our nation’s low income families. In 2013 and 2014, however, federally distributed funds allowed Medicaid payment rates for many primary care codes to be increased to that of Medicare payment rates. This funding enabled primary care doctors, particularly pediatricians, to see Medicaid patients that they otherwise may not have been able to see because of reimbursement factors. This funding expires January 1, 2015, however. The Ensuring Access to Primary Care for Women and Children Act (S. 2694) would extend federal funding to support increased Medicaid payment rates for at least two more years. This legislation is critical in that it allows providers to broaden their practice by giving care to a larger group of people in the United States.
The future of CHIP is much more uncertain because the program is at risk of being eliminated completely. Although CHIP is approved through 2019, the federal funding for it is only authorized through October 1, 2015. It is imperative that Congress extend funding for CHIP via the CHIP Extension Act of 2014 (S. 2461) and the CHIP Extension and Improvement Act of 2014 (H.R. 5634) because without extension, states will be unable to budget effectively. Without federal assistance, states will be left without adequate funding for CHIP and will likely abandon the program. Passage of these bills will continue this CHIP funding for four more years, enabling pediatricians and other primary care providers to care for our nation’s children more effectively.
Please communicate with your US Senators and Representatives to urge them to pass these critical pieces of legislation.
Lauren Lazar, MD
http://www.cms.gov/About-CMS/Agency-Information/History/index.html?redirect=/history/
http://www.aap.org/en-us/advocacy-and-policy/federal-advocacy/Documents/AugustRecessTPs.pdf
Pediatric Advocacy 