At Risk: Medicaid’s Child-Focused Benefit Structure Known as EPSDT

The federal benefit standard in Medicaid ensures that low-income and vulnerable children receive the health care services they need to grow and thrive. But this standard is at risk. Proposed cuts to Medicaid and CHIP funding could make EPSDT unaffordable to states, and in turn, proposed changes to federal policy, including legislative and administrative action, could potentially give states the option to eliminate the standard except as it applies to children with disabilities. Such a move would be shortsighted as children with serious disabilities make up only a small share of children enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) who benefit from EPSDT.