This issue brief provides a comprehensive look at the EPSDT benefit, including a plan-to-plan comparison with large scale health plans in two states and the Federal Employee Health Benefit Program (FEHBP). That comparison shows that Medicaid’s EPSDT benefit consistently offers more comprehensive coverage for children and greater financial protections for families. It is the gold standard in children’s health coverage.
Health Coverage Matters for Children: The Role of Medicaid in the Healthy Development of America's Children
Access to health care is crucial to children’s health and development. When children have health insurance, they are more likely to get the health care they need. For more than 40 percent of children in the U.S.—approximately 37 million children—Medicaid is the health insurance they rely on. Another 8.9 million children are enrolled in the Children’s Health Insurance Program (CHIP), Medicaid’s sister program. The success of Medicaid and CHIP is largely responsible for the fact that 95 percent of children under 18 have some form of health coverage.
This brief highlights the value of integrating CHWs into maternal and child health care delivery to effectively address a range of health care concerns and conditions for children and families, offering examples of specific initiatives that are promising or have demonstrated impact in improving health care and health outcomes for children of color.