A Looming Threat to Public Insurance Programs for Children with Special Health Care Needs

Negotiations now under way in Washington, DC, regarding the U.S. debt ceiling could have a catastrophic effect on some of California's children with special health care needs and their families.

Many children in our state depend on public health insurance programs to meet all or part of their health care costs, through Medi-Cal (California's Medicaid program) or Healthy Families (California's State Children's Health Insurance program). The State Flexibility Act, currently under debate in Congress in conjunction with the debt negotiations, would reduce spending and allow states to make cuts in eligibility for these vital programs. Potential scenarios for California could include complete elimination of Healthy Families, and limits placed on the number of children eligible for Medi-Cal.

Such changes would have a particularly negative effect in California, where more than a third of California's children with special health care needs already have insurance that is not adequate to meet their requirements, according to Children with Special Health Care Needs: A Profile of Key Issues in California, a report commissioned by our Foundation. Our state ranks 46th out of the 50 states on adequacy of insurance for children with special health care needs, the report notes.

The Medicaid and Healthy Families programs have contributed substantially to improving the health and well being of children, and these programs are especially critical for children with complex and chronic conditions. A new study from Georgetown University's Center for Children and Families documents how much is at stake if these programs are cut or lost. Without insurance, children may lose access to primary care, specialists, early intervention programs, or preventive services that help keep their conditions from worsening. Medicaid also helps many children live and be cared for in their homes and communities rather than in institutions.

Attempts to alter these essential public insurance programs have been made before. This time around, however, the crisis is so severe that some supporters in Congress are pessimistic. In a recent Wall Street Journal article, Senator Jay Rockefeller (D-WV), a longtime Medicaid advocate said, "There has been an unsettling silence around Medicaid even from members of my own party."

As the negotiations about reducing the national debt proceed, it is imperative that we add our voices to the debate. Let your Congressional representatives and the Obama Administration know what it means for children and families to lose access to the health care they deserve.

You can find your representatives at http://www.govtrack.us/congress/findyourreps.xpd, or call (202) 225-3121 for the Capitol switchboard and (202) 456-1414 for the White House. Ask them to protect Medicaid and the State Children's Health Insurance Program.

I also encourage you to join the new California Collaborative for Children with Special Health Care Needs, a statewide group developed by our Foundation that will be working toward a better system of care for children in California with special health care needs.

Posted July 15, 2011


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