We have often said that one of the very important features of Medicaid’s financing structure is the program’s ability to address emerging short and long-term public health crises. And previous national emergencies such as Hurricane Katrina and 9-11 also resulted in state leaders of all political persuasions looking to Medicaid to help them address critical health care needs.

So it should come as no surprise that Medicaid is forming the backbone of the Michigan Governor’s request to address the very serious and pressing health care needs of the children (and pregnant women) of Flint. The issue of lead poisoning is one that poses many challenges for children and families nationwide –- I fear and suspect there are a lot more Flints out there. So a longer term agenda item is to revisit how screening requirements and treatment needs are being met for children who rely on Medicaid coverage in Michigan and elsewhere.

But for the moment, the Governor has submitted a Section 1115 waiver request to extend eligibility in Medicaid and CHIP to children living in Flint in families earning up to 400% of the federal poverty line and provide them and their families with a range of services. Currently children in Michigan are covered up to 217% of the poverty line – quite a bit below the national median of 255%. Under the Governor’s proposal, Michigan families earning over 400% could buy Medicaid coverage at full cost. All good ideas, but we believe there are some ways in which this could be a stronger proposal for kids and families. Our short comments to that effect are available here.