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Issue Brief
June 2018

How Medicaid Protects Children with Special Health Care Needs

Half of U.S. children with special health care needs, nearly 7 million children, rely on Medicaid/ Children’s Health Insurance Program (CHIP) for health insurance to cover some or all of their medical care. Medicaid and CHIP cover 48 percent of children with special health care needs. CHIP, which covers low- to moderate-income children above the Medicaid income limit, is administered by states sometimes as a separate program, but often through state Medicaid programs.

As this issue brief explains, while Medicaid is a major source of health care insurance for all children in the United States, covering 40 percent of children, it is particularly vital for children with special health care needs. 

There are many reasons why—and each of these is discussed in greater detail in the brief:

  • Compared to private insurance, Medicaid offers more comprehensive coverage for the types of services and supplies these children need. In fact, the services and supplies many of these children need are not generally covered by private insurance at all, or coverage is very limited.  
  • Medicaid makes ongoing medical care more affordable, especially for families with children who have ongoing or lifelong medical needs. By law, Medicaid cost sharing, deductibles, and premiums are low. That’s critical, given the high cost of caring for a child with special health care needs, which would bankrupt many families in the absence of Medicaid.
  • The comprehensive range of services that Medicaid offers includes services and supports that can help parents or other caregivers to continue working. Medicaid ensures a path for families to maintain income stability and avoid medical bankruptcy, risks that they might otherwise face as they care for a sick or disabled child. In that way, Medicaid supports entire families.  

Both state Medicaid cuts and federal efforts to restructure or cut program spending inherently impact the health of these children, as well as their, and their families’, financial well-being.