Today, a group of 18 national children’s advocacy, provider, and health advocacy groups joined together to voice their deep concern to the Obama administration about Utah’s recent request to cut children’s health care and to dramatically increase the cost of care for their families. The group urged Health and Human Services Secretary Kathleen Sebelius to reject the request unless children are appropriately protected.
“There is deep concern that if this is approved it opens the door to very harmful effects on children in Utah,” said Joan Alker, Co-Executive Director of the Georgetown University Health Policy Institute Center for Children and Families. “But the reason national groups are speaking out is because if a waiver is approved it would set the precedent for other states to follow Utah’s lead and put children’s coverage at risk.”
In a letter delivered today to Secretary Sebelius, the group wrote, “Utah’s demonstration proposal seeks to waive the requirement that the state provide Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) — the Medicaid benefit for children. EPSDT embodies Medicaid’s objective of providing children with the services that are medically necessary for their healthy growth and development. Utah also proposes to waive Medicaid’s cost-sharing protections, potentially exposing very low- income families to unaffordable medical costs in some new and troubling ways. The proposal would give accountable care organizations the authority to set co-payment amounts up to a maximum specified in the proposal and to pick and choose what co-pays to charge to children to act as “client incentives.” We do not believe it is appropriate for insurers to decide whether children have to pay more to access needed health services as a result of their (or more likely their parents’) behavior.”
The letter went on to state, “Research has shown that cost-sharing places a heavier burden on those with low income: they often delay or reduce their use of needed care, leading to poor health outcomes. Medicaid’s cost- sharing protections assure that a family’s lack of resources does not impose a barrier on access to care for the lowest-income children. CMS should not allow Utah’s demonstration to introduce such barriers for these children, barriers that do not exist anywhere else in the country.”
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