Texas children need a healthy Medicaid program: Stacy E. Wilson

April is Medicaid Awareness Month—a time dedicated to highlighting the vital program that provides health coverage to approximately half of the 8 million children living in Texas. Medicaid is critical not only to these children and their families but also to Texas’ comprehensive children’s hospitals, as 75% of Medicaid enrollees are children. In El Paso County alone, more than 138,000 children under age 21 are enrolled in Medicaid.

Medicaid provides coverage for regular medical, vision, hearing and dental screenings, as well as critical services to treat physical or mental health conditions. Medicaid also covers long-term care services not typically covered by private insurance that help children with special healthcare needs remain at home with their families rather than staying in a more institutional setting. Medicaid ensures that children with medically complex conditions have access to life-saving care that often only comprehensive children’s hospitals can provide.

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At El Paso Children’s Hospital, 33,335 patients were covered by Medicaid in 2021 alone. Without adequate, predictable Medicaid reimbursement, the services provided by comprehensive children’s hospitals like El Paso Children’s Hospital would not be available to any child.

Centers of excellence and expertise

Comprehensive children’s hospitals are regional—and often national and worldwide—centers of excellence and expertise. As not-for-profit entities, these hospitals invest in their communities to meet the needs of children and families in many ways, such as by funding pediatric specialists to relocate to Texas and care for our children. Comprehensive children’s hospitals also create and expand programs to meet the growing population of children in Texas and their evolving healthcare needs.

Studies have proven that children with access to Medicaid are more likely to graduate from high school, go to college and become healthier adults who will earn more and pay more in taxes than those who do not receive appropriate health care as children.

Three important areas of focus

On behalf of our member hospitals, the Children’s Hospital Association of Texas is focusing on three important areas:

●      Children’s hospitals are heavily reliant on Medicaid, given the number of children enrolled in Medicaid and the fact that children’s hospitals have only two primary sources of funding: Medicaid and private insurance. Hospitals that treat adults receive Medicare payments, which are usually higher than Medicaid payments. Anything that happens to Medicaid payments affects children’s hospitals more than other hospitals. So adequate, predictable Medicaid payments are vital to these hospitals.

●      The federal government recently approved certain Medicaid payment programs that will benefit all hospitals serving Medicaid patients. Despite this approval, these programs remain uncertain for a variety of reasons. To ensure the continued viability of all Texas hospitals, especially those that treat large numbers of Medicaid patients, it is imperative that these programs function as approved and that hospitals receive and retain the program payments. 

●      Higher numbers of children and teens are now experiencing more severe mental health issues—suicide attempts, suicidal ideation and self-harm—than before the pandemic. Children’s hospitals need additional infrastructure to care for these children, including workforce and services, especially inpatient services, partial hospitalization programs and intensive outpatient programs. Without sufficient Medicaid funding, children’s hospitals cannot begin to make the investments needed to serve these children.

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Vital pediatric safety net

Children’s hospitals are a vital pediatric safety net for all Texas children. CHAT member hospitals are committed to the health of the most vulnerable children across the state, serving all children who come through their doors. Medicaid makes it possible for these hospitals to continue providing that level of specialized care.

Every El Pasoan has an interest in children’s well-being, as these children are your kids, nieces, nephews, and grandchildren. As those children are affected by the healthcare decisions made by our public officials, it is important to stay informed and updated on Medicaid and children’s healthcare news in Texas—especially before our representatives reconvene in January. Sign up for the CHAT newsletter at CHATexas.com for the latest information and how you can ensure all Texas children have access to proper health care.

Stacy E. Wilson is president of the Children’s Hospital Association of Texas. CHAT members are Dell Children’s Medical Center of Central Texas (Austin), Driscoll Children’s Hospital (Corpus Christi), Children’s Health (Dallas), El Paso Children’s Hospital, Cook Children’s Health Care System (Fort Worth), Texas Children’s Hospital (Houston), and Covenant Children’s Hospital (Lubbock).