3/8/2018 Children's Hospitals, the Importance of Health Insurance & Medicaid for Children with Disabilities & Special Health Care Needs Lisa Chamberlain and Sherri Sager have nothing to disclose. Sherri R. Sager, MPA Lisa Chamberlain, MD, MPH Stanford Children’s Health Medicaid/CHIP– Who are the Children Covered? • Covers about half (48%) of children with special needs (2016) • Share of Children with special health care needs covered by Medicaid/CHIP varies by state from 23% 67% • 75% of Medicaid/CHIP children with Special Health Care Needs live in families below 200% of the FPL 1
3/8/2018 Medicaid – What it Means for Children Medicaid – What it Means for Children • Medicaid and Children’s Health Insurance Program (CHIP) benefit • Enables low income children to obtain needed care without co- children in part because they help families, not just children payments or deductibles • Cost-effective programs • Inexpensive way to cover children • Benefits include: • When parents are covered, children more likely to receive recommended preventive care • Less likely to miss school • Healthier into adulthood • Access to prenatal care reduces infant mortality and morbidity • Earn higher wages Medicaid is the Underpinning of entire health care delivery system for • Pay more in taxes all children • Volume expertise 2
3/8/2018 Medicaid – What it Means for Children’s Affordable Care Act Hospitals • Children’s Hospitals see more Medicaid patients than the vast • For families and persons with pre-existing conditions and/or majority of other hospitals disabilities – LifeSaver • No Annual Caps • In CA, the range at children’s hospitals is 43% 75% • No Lifetime Caps • Allows for the development of Needed Pediatric Expertise • Health Insurance Affordable – i.e. can’t discriminate regarding pre-existing • Foundation of financial sustainability conditions • Supplemental programs • Expanded Medicaid Eligibility • DSH • GME • Provider Fee Future of Medicaid - Challenges • Attempts will continue to repeal all of the ACA, especially the Medicaid expansion • Cut eligibility • Cut benefits • Cut funding • Block grants • Per capita cuts • Most Serious – A Non-Realistic Understanding of What Medicaid is and Does by a Significant Number of Elected Officials and Appointed Officials 3
3/8/2018 “ Pediatricians are the Why us? ultimate witnesses to failed social policy ” Paul Wise Mobilizing for Child Health We had two main goals Organize and strengthen our local • Town Hall Fall 2016 professional community to better • Medicaid advocate for children at • Immigration the policy level • Pediatric Research Funding Educate the next generation of • All welcome pediatrician-advocates • Faculty on policy issues that • Staff impact our patients • Trainees 4
3/8/2018 We organized resident conferences How we’ve taken action We spoke at congress members’ town halls We organized a letter writing campaign 5
3/8/2018 We coordinated our efforts with the AAP We collaborated with other institutions We posted our #FirstTweets We organized advocacy events… 6
3/8/2018 ...and advocated as a community Taking Action to Protect Kids in Medicaid #DontCapMyCare 5,804 posts 3,922,689 individual people #KeepKidsCovered 8,004 posts 8,805,612 individual people We met with members of congress in D.C. We created a story bank “A mother of two school-age children with terrible oral sores was afraid to come to the doctor or the emergency room because she has an electronic bracelet and is worried about getting deported. She was so scared to come in that by the time they arrived, both children were severely dehydrated.” 7
3/8/2018 We had the support of our institution How did we make it happen? We built an infrastructure for rapid response We held regular core team meetings 8
3/8/2018 California What could this look like going forward? Pediatric Training Collaborative Community peds Interdisciplinary training UC Davis CHRC Oakland UC San Francisco Lucile Packard CH Legislative advocacy Join forces with other voices – training & statewide advocacy Parents and Patients CH Orange County CHLA Harbor Medical UCLA UCLA Kaiser LA UC Irvine Loma Linda UC San Diego Navy Medical San Diego Advocacy Role – State Partnership with AAP Immunizations Protect WIC and SNAP Residents from across CA come to Sacramento 9
3/8/2018 Built / Funded / Underway (2016-17) TOTAL: 57 NY: 30 MO: 4 CA Total: 15 NC: 5 SC: 3 Supported by The California Endowment, The Duke Endowment, The Missouri 37 Foundation for Health Assessing Feasibility / Needs Assessment (2018) On Deck (2019) TOTAL: 33 TOTAL: 24 NJ: 9 PA 8 OH: 10 IL: 11 TX: 13 AR: 1 GA: 5 10
3/8/2018 Vision by 2020 Summary TOTAL: 114/198 • Medicaid is the vital foundation for child healthcare in the US • Medicaid plays an especially important role for children with medical complexity • We are at an “all hands on deck” moment – it is time to unify and speak up for kids. Thank You @LisaChaMD @SherriRSager Lchamberlain@Stanford.edu ssager@stanfordchildrens.org 11
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