Fifty years ago this week Medicaid and Medicare were signed into law. These two programs provide children, seniors, people living with disabilities and working families with access to the health care they need. To celebrate 50 years of these two programs, each day this week one of our partners will share a story about their work to ensure more people can access Medicaid. We’ll also be reflecting on the two programs and what’s ahead.
At Voices for Virginia’s Children, we are reflecting on Medicaid’s 50th anniversary and what the program has meant to generations of children and families here in Virginia.
If children don’t have adequate access to health care – both preventive care and treatment – few of our other goals for them are attainable:
- Lack of routine well-child visits in young children can mean missing the diagnosis and treatment of developmental delays, which can cause kids to struggle in school.
- Kids without health care coverage don’t get taken to the doctor when they’re sick; instead, illness can escalate until costly and crisis-oriented emergency care is required.
- Without health insurance for their kids, parents also miss the age-appropriate guidance from pediatricians or family physicians about developmental milestones to help them provide optimal care for their children.
Nationally, more than 71 million children now access health care because they have coverage through either Medicaid or the Children’s Health Insurance Program (CHIP). In Virginia (you can check your state here), almost one million kids have this coverage, either through Medicaid, for families who earn a little above the poverty line (143 percent of the federal poverty level) and FAMIS (our CHIP program) for families who earn up to twice the federal poverty level. (The federal poverty rate in 2015 is a meager $24,250 for a family of four.
Medicaid’s Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) benefits for children are “a model for pediatric care.” EPSDT provides comprehensive coverage, including dental, vision and hearing screenings and treatment – recognizing that kids whose teeth hurt or who cannot see or hear the teacher are not going to be able to learn. In fact, research shows that increased enrollment in Medicaid and CHIP not only have a positive effect on child health indicators such as obesity and teen pregnancy, they also have a positive effect on academic achievement.
We celebrate the success of Medicaid because kids are still struggling in poverty at disproportionate rates in this country. In Virginia, almost 300,000 children live below the poverty line—what’s worse, we are one of only 10 states in which the child poverty rate got worse between 2012 and 2013. Kids growing up in poverty are already starting out behind their peers in more economically secure families. Yet for all the ways these kids may have the deck stacked against them from the start, health care doesn’t have to be one of them—and for that we can credit Medicaid.
Just as kids in poverty struggle to succeed in life if they don’t have regular access to health care, their parents do, too. Research shows us that when parents don’t have health insurance, the whole family is at risk.
- Uninsured parents with chronic illnesses often have to go without needed treatments, making them less able to provide consistent care for their kids.
- In low-income families, one medical emergency for a parent without insurance can mean financial ruin—making it impossible to meet their kids’ basic needs.
- Untreated maternal depression can have dire, lifelong consequences on the wellbeing of young children.
Many states have figured out that allowing low-income, uninsured adults – including the 25 percent who are parents of children younger than 18 – to enroll in Medicaid according to the provisions of the Affordable Care Act is a smart investment in our future. Not only will we have a healthier workforce now, we will improve the health and academic trajectory of tomorrow’s workforce. Kids whose parents are insured are more likely to have insurance themselves and be taken to the doctor for routine care.
Unfortunately in Virginia, Medicaid coverage is very restricted for adults in poverty, including parents. Depending on where in the Commonwealth you live, making as little as $7,980 a year could mean you earn too much as a parent in a family of four to qualify for Medicaid.
The great news is that we have an opportunity to improve the situation for low-income families, helping both parents and kids by closing the coverage gap between existing adult Medicaid eligibility levels and eligibility for tax credits in the Marketplace. As child advocates, we are still working with many others to find a Virginia-specific solution to the dilemma of uninsured, low-income adults.
So while we celebrate the generations of kids who have grown up with access to comprehensive health care because of Medicaid, we must also seize the opportunity to improve outcomes for kids and parents in the future through increased Medicaid coverage.
--Margaret Nimmo Crowe, Executive Director, Voices for Virginia’s Children