A. new KFF analysis examines the key characteristics of children with special health care needs, the affordability and adequacy of their health coverage, and the implications for such children of potential new federal Medicaid money to help families care for them.
Medicaid is an important source of coverage for medical, behavioral health, and long-term services and supports for children with special health care needs, including home and community-based services (HCBS) they need to live at home with your families. During the pandemic, children have experienced interruptions in health care, mental health problems and financial difficulties, and these problems may have intensified for those with special health care needs.
The American Rescue Plan Act provides a temporary increase in federal Medicaid matching funds for state spending on HCBS. As part of the budget reconciliation legislation, the House is currently considering $ 190 billion in additional Medicaid HCBS funds that states could use to support the HCBS provider workforce, offer new or expanded HCBS benefits, and / or serve more HCBS affiliates, although the final funding amount has not yet been established.
The analysis provides a context for ongoing political discussions. The key findings include:
• Medicaid / CHIP covers nearly half of the 13.9 million children in the US with special health care needs, although the proportion varies by state.
• Children with special health care needs covered by both Medicaid / CHIP and private insurance have the greatest health care needs, and children who are covered only by Medicaid / CHIP are more likely to have the greatest health needs compared with those who only have private insurance.
• While families of children with only Medicaid / CHIP who have special health care needs are more likely to face financial hardship, they find their health care more affordable than those with only private insurance. This is due to Medicaid cost-sharing protections.
• Even though children with special health care needs covered by Medicaid / CHIP only have greater health care needs, they are more likely to report that their benefits are always adequate to meet their needs than those with only private insurance.
For the full analysis, as well as other data and analysis on healthcare priorities in the budget reconciliation discussion on Capitol Hill, visit kff.org.