Analysis Examines Insurance Coverage,
Affordability and Access to Home and Community-Based Services for
Children with Special Health Care Needs
A new KFF
analysis examines 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 assist families in caring for them.
Medicaid is a
significant 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) that they need
to live at home with their families. During the pandemic, children have
experienced health care disruptions, mental health challenges, and
economic hardships, and these issues may have been 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 currently is considering $190 billion in additional Medicaid
HCBS funding that states could use to support the HCBS provider
workforce, offer new or expanded HCBS benefits, and/or serve more HCBS
enrollees, though the final funding amount has not yet been set.
The analysis provides
context for those ongoing policy discussions. Key findings include:
• Medicaid/CHIP covers
almost half of the 13.9 million children in the U.S. with special health
care needs, though the share 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 greater health needs compared to
those with private insurance only.
• While families of
Medicaid/CHIP-only children with special health care needs are more
likely to face financial difficulty, they find their health care more
affordable than those with private insurance only. This is due to
Medicaid’s 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 than those with private insurance
alone to report that their benefits are always adequate to meet their
needs.
For the full analysis,
as well as other data and analyses about health care priorities in the
budget reconciliation discussion on Capitol Hill, visit
kff.org.
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