All in all, there has been some good news for kids. The Finance Committee’s modified proposal still raises substantial questions about whether the coverage will be affordable for families as Jocelyn discussed. But looking at where kids stand there has been a genuine effort to respond to the many concerns raised by childrens’ advocates to ensure that coverage is comprehensive and affordable. The Chairman’s mark includes a provision that all children under 250% of the federal poverty level will be eligible for Medicaid’s gold standard for kids – the EPSDT benefit. While there are real concerns about how this provision will be implemented (particularly in some of our less enthusiastic states!) this is a major step forward for kids. And the mark includes a requirement that cost-sharing for kids do not exceed current levels in their Child Health State Plan as well as a requirement that HHS certify that the new exchange plans will meet these requirements before kids are allowed to flip over.
There were a few amendments debated of relevance to kids. A Menendez amendment permitting child-only policies to be offered in the new exchanges was easily adopted. A Grassley amendment, which increased reimbursement for pediatric providers in Medicaid, was rejected because it was financed by eliminating subsidies for families from 300-400% FPL. While we would all like to see more resources go to these providers, this was not the way to pay for it.
So stay tuned next week as we see where the Finance Committee goes next. But advocates for children should feel good about the fact that key concerns, while many questions and many more key decisions lie ahead, are being addressed.