Fighting For Access To Care: Medicaid & Legislative Support For Children

Children’s Hospital & Medical Center is the only hospital in the state that is completely dedicated to pediatric patients. We are experts in providing pediatric care and understanding children’s unique medical, developmental, and social needs.

And as the only safety-net provider for children and Nebraska, serving children who need specialized and highly-acute care, we are also well versed in how difficult it can be for families to afford care and how legislation impacts pediatric care.

That’s why we are on the front lines.

We’re not just dedicated to providing top-quality care. We’re also committed to ensuring that care is affordable and accessible, and that children with complex medical needs are represented fairly in the legal system.

Our Advocacy & Outreach team is consistently and passionately involved in fighting for Medicaid and other legislative priorities at both the federal and state levels.

Learn more about our priorities.

Children’s Advocacy and Legislative Support in Action

Legislative Update 10/04/2021: Supporting Students, Helping Kids Cope, And Other Pediatric Opportunities

This is the legislative update for October 4, 2021.

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Legislative Update 9/27/2021: Budget, mental health, report from the Inspector General of Nebraska Child Welfare

This is the legislative update for September 27, 2021.

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Legislative Update 9/20/2021: Impact of COVID-19, Budget, Nebraska Legislature

This is the legislative update for September 20, 2021.

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Legislative Update 9/13/2021: PATCH Act, Provider Relief, Nebraska Legislature

This is the legislative update for September 13, 2021.

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Legislative Priority: Access to Care Through Medicaid

Our main legislative focus is Medicaid, which is a joint program of the federal and state governments. State and the federal government work together to cover necessary medical services for low-income families and children who meet certain criteria.

Why We Focus on Medicaid

At Children’s and across the country, pediatric hospitals face the same reality: Medicaid is the primary payor. As children’s hospitals are challenged to provide quality and accessible care, and expanded programs to meet the growing needs of this vulnerable population, Medicaid payments are essential — but they are not nearly sufficient enough to cover the cost of care.

Here at Children’s Hospital & Medical Center, we are no strangers to Medicaid. We are the only safety-net provider for children in Nebraska and we serve children who have specialized and highly-acute care. And over the past few years, we have seen a steady increase in the volume of our patient population that relies on Medicaid for health insurance coverage.

Fast Facts
  • Children make up nearly 50% of all patients enrolled in Medicaid, but only account for 20% of the cost.
  • Of all the children enrolled in Medicaid, 6% are medically complex.
  • Medicaid-enrolled children with medically complex needs account for 40% of pediatric Medicaid charges. This makes them most vulnerable to changes in Medicaid funding.

Fighting for Medicaid: Children’s On the Front Lines

When a child is faced with a devastating diagnosis, it is often difficult for their family to cover the out-of-pocket costs for care — even with insurance. It’s common for children who need complex medical treatment to be enrolled in Medicaid as a secondary payor to offset those costs.

Multiple attempts have been put forth by Congress to fundamentally restructure Medicaid financing, with the goal of saving money for the federal government in both the short- and long-term. However, the type of restructuring they propose would erode health coverage for children and families.

We need to fight to preserve Medicaid for the children who need it the most and to ensure that all children — regardless of their family’s ability to pay — get the care they need and deserve. That’s why we’ve chosen access to care through Medicaid our top priority.

Other Legislative Priorities

In addition to Medicaid, we also advocate in support of:

ACE Kids Act

The Advancing Care for Exceptional (ACE) Kids Act (H.R. 3325/ S. 428) is designed to improve care for children with medical complexity in Medicaid, while also reducing program spending. It expands access to patient-centered, pediatric-focused coordinated care models tailored for children with complex, chronic conditions.

340B Drug Pricing Program

For 25 years, the 340B Drug Pricing Program has provided financial help to safety-net hospitals to manage rising prescription drug costs. The program allows 340B hospitals to stretch limited federal resources to reduce the price of outpatient pharmaceuticals for patients and expand health services to patients and the communities they serve.

The Children’s Health Insurance Program (CHIP)

The Children’s Health Insurance Program (CHIP) is a bipartisan effort to provide health coverage to children who fall above Medicaid eligibility levels, but struggle to afford private insurance. CHIP is a joint federal-state program designed with children’s needs in mind, including pediatric-specific benefits and appropriate provider networks. Out-of-pocket costs are capped at 5% of a family’s income in CHIP, which helps ensure low-income families have access to affordable care.

Children’s Hospital Graduate Medical Education Payment

The Children’s Hospital Graduate Medical Education Payment (CHGME) program provides independent teaching children’s hospitals with federal funding to support the training of approximately 6,000 physicians annually.

Disproportionate Share Hospital (DSH)

Medicaid Disproportionate Share Hospital (DSH) payments are required to provide financial support to hospitals that serve a large number of Medicaid and uninsured patients. We are working to stop or delay cuts to the program.

Legislation To Watch

We have put together a list that includes only a handful of bills that Children’s is monitoring on behalf of the patients and families we serve across the state.

How to Get Involved

  • Contact your senator: You can find out who your senator is as well as their address, phone number, and email, at the Nebraska Legislature website. Write a letter, make a call, or send an email. If you are a Children’s employee or family member of a patient, please contact Liz Lyons, Director of Advocacy & Government Affairs, first for guidance on how to craft your message: llyons@childrensomaha.org.
  • Follow legislative hearings and live debates: Visitors can watch the Legislature in person. You are welcome to watch from the third-floor balconies in the Norris Chamber. You can also watch remotely. Nebraska Educational Telecommunications (NET) provides live broadcasts of public committee hearings and legislative floor activity. View a livestream, watch videos of previous broadcasts, and find out about upcoming broadcasts on the NET website.
  • Testify at a committee hearing: Committees may consider several bills in an afternoon. Most bills and government appointments include time for testimonies from community members. Learn more about testifying in person on the Nebraska Legislature website. If you are a Children’s employee or family member of a patient, please contact Liz Lyons, Director of Advocacy & Government Affairs, first for guidance on how to craft your message, at llyons@childrensomaha.org.
  • Connect with relevant organizations:
  • Join the Child Health Champion Advocacy Team every Thursday at 7:30 a.m. for a 30-minute call. This internal group of stakeholders — comprised of providers and experts across the continuum of care at Children’s — meets weekly to ensure we are leading the discussion on child advocacy in the region. If you are interested in joining the movement, contact Liz Lyons at llyons@childrensomaha.org for more information.

What To Do Next

For more information on policy advocacy, government affairs, legislative support at Children’s, contact Liz Lyons, Director of Advocacy & Government Affairs, at 402-955-4139 or llyons@childrensomaha.org.

Liz Lyons Director Government Relations

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