As Washington’s new leaders begin their first days in office, they do so with promises of big, quick changes to the health care system.
Congress has begun developing its fiscal 2018 budget, intent on reversing several Affordable Care Act provisions. Elected officials are also considering changing Medicaid, including how it is funded, how it pays for services and the role enrollees play in their care.
Medicaid, however, is a more complex program than most understand. Wholesale changes to funding mechanisms may have adverse consequences for many who rely on it.
One such group is children with special health care needs, which includes over 1 in 7 children in the United States. For instance, “Care at Home” waivers allow children with long-term disabilities or complex medical needs to qualify for Medicaid regardless of family income.
Due to medical advances, many of the 11 million U.S. children with special health needs now lead long, full lives—a number expected to double over the next decade. They have, or are at risk for, chronic conditions, which often require a spectrum of health care services. They benefit greatly from highly coordinated care, and safety net plans like YourCare Health Plan are experts in that coordination.
Lack of coordination leads to fragmented care, e.g., repeated tests, postponed visits, missing health records or lost referrals. For families with special needs children, this can be frustrating. A new report from the Association for Community Affiliated Plans highlights the efforts safety net plans take to coordinate care and relieve these frustrations. The report is available at www.communityplans.net/research/specialneedscarereport.
YourCare advocates for these children. It’s not enough to just offer coverage. To make a difference in their lives, we assist their families with life’s essentials: food, clothing, shelter, education and transportation. We believe it’s our responsibility to do this.
Our specialists assist families in understanding the complicated world of health care, which, as we saw last week, even our new president has now recognized, as he made headlines by saying, “Nobody knew health care could be so complicated.”
Indeed, many of us did.
Medicaid has evolved substantially since its founding in 1965. There are solutions that could improve it; indeed, we work to find them every day. But we also know that, like all who rely on the health care system, children with special health needs require consistency, quality and—above all—coverage. Quick, dramatic changes may substantially disrupt that coverage for millions—and destabilize the business environment for safety net health plans in the process.
Dennis Graziano is president and CEO of YourCare Health Plan Inc.