Children frequently lose health care coverage for months at a time as a result of the onerous procedure of parents renewing their children’s Medicaid each year. Phone calls are skipped and never returned, renewal letters are misplaced in the mail, and verification documents are filed but never handled. Children lose coverage, and families are unable to get the critical treatment their children require. The outcome is the same.
I have worked in Medicaid policy for almost 15 years. I worked for a legal nonprofit for six years before to joining GEEARS, helping low-income Georgians in the 154 counties outside of metro Atlanta. I took hundreds of calls every month at that time from anxious parents and caregivers who shared the same devastating worry: My child’s Medicaid was terminated even though we were still qualified.
A few incidents have stayed with me:
- A mother phoned from an emergency room. Her daughter had a broken leg, but the hospital refused to set it because her Medicaid had been terminated. They sent the child home with only pain medication.
- A grandmother reached out in distress. Her grandson s Medicaid had been cut off, and he hadn t had his ADHD medication in months. He d been suspended from school, and his grades were plummeting.
- A mother, standing outside a surgery center, had just been told her daughter s scheduled ear tube surgery was canceled. Medicaid was showing as inactive, even though they had submitted all the requested information.
The child was nonetheless qualified for coverage in each instance. These were systemic flaws rather than eligibility issues.
For this reason, the Georgia Early Education Alliance for Ready Students, or GEEARS, has long pushed for Georgia to implement a Medicaid waiver that would guarantee children’s coverage from birth to age three. The basis for long-term health and learning is laid throughout the formative years of life, when stable access to care is essential for brain development. During the first three years of life, routine pediatric visits, vaccinations, developmental tests, and early interventions are all crucial.
In addition to helping children and families, ongoing coverage would ease the burden on state agencies by reducing the amount of documentation caseworkers have to go through.
Nevertheless, the Centers for Medicare and Medicaid Services (CMS) said in a memo on July 17th that it would no longer grant or extend Section 1115 waivers that grant young children continued Medicaid coverage. This ruling jeopardizes the waivers that have already been issued in nine states as well as the waiver proposals in a number of other states.
Although the legally required Comprehensive Health Coverage Commission suggested seeking one for children up to age six in its report last December, Georgia never filed such a waiver. The policy may have stabilized care for the almost 50% of babies whose births are covered by Medicaid if it had been put into effect.
That amounts to more than 60,000 infants last year, 60,000 children who should have unhindered access to medical care during the most critical developmental years. This waiver provided a clear-cut remedy. CMS has obstructed a vital avenue for enhancing early childhood health outcomes in Georgia and nationwide by discontinuing this option. It’s an extremely disheartening choice that ultimately hurts our children, who are our country’s most valuable resource.
