Complete Children’s Health! Receive Complete Health Care for Your Children
The Congress is currently working to reauthorize the State complete children’s health insurance program. There are many contentious issues, including funding levels, formula allocations, enrollment requirements, eligibility, and enrollment requirements. In 1997, the SCHIP benefit structure (which includes cost-sharing as well as covered benefits) was a major issue. It has been relatively ignored in the current debate.
Many parties, including a conservative think tank or insurance industry players have proposed changes that could significantly impact the benefits that low-income children may receive.
Two of their suggestions should prompt a reconsideration of how Medicaid, SCHIP and private coverage benefit programs meet the health care needs of low-income children in different ways. The first is that SCHIP reauthorization money should be used for tax credits and other financing mechanisms. Second, the state SCHIP programs need to focus more on enrolling children in private or employer-based coverage.
Benefit Complete Children’s Hospital Design for Reauthorization & SCHIP
The American Academy of Pediatrics updates its recommendations on complete children’s health benefits regularly. All children can benefit from the AAP recommendations. These recommendations do not apply to low-income children. They can be used to help determine whether children should have private or public insurance. The AAP recommends pediatric surgery, critical care, medical care, and pediatric surgery. It also recommends behavioral health services, special care for children with special needs, and pediatric dental care.
These recommendations are extensive and highlight the importance of health services in a child’s life. This includes lifelong skills such as speech and exercise, as well as improved school performance due to better hearing and vision. These recommendations don’t address benefits limits that are part of both public and private coverage. They also impact children’s access to health services and their use across all income levels. These policies do not address cost sharing plans for these services. Children with lower incomes may not be able to access benefits due to copayments or deductibles.
Professor Sara Rosenbaum of George Washington University and Dr. Paul H. Wise from Stanford University both noted that private insurance products can offer limited coverage terms but they are not designed to finance the many developmental conditions children may experience. According to the authors, private insurance is not designed to cover developmental and chronic conditions. Administrators have wide discretion when approving or denouncing coverage. Rosenbaum and Wise also note that private coverage doesn’t cover certain services because of service setting, diagnosis or other “hard” limitations.
A few surveys about health care give information on employer-based coverage for certain benefits. This covers prescription drugs as well as behavioral health. This may be of particular interest to children and adolescents. These surveys revealed that while most workers and dependents have access, the vast majority are subject to significant restrictions.