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AAP Response to U.S. Supreme Court Armstrong v. Exceptional Child Center Ruling

​by: Sandra G. Hassink MD, FAAP, president, American Academy of Pediatrics

“Today’s U.S. Supreme Court ruling in the case Armstrong v. Exceptional Child Center is a significant disappointment for children enrolled in the Medicaid program, and the pediatricians and physicians who care for them. The ruling denies the opportunity to challenge low payment rates and creates an enormous barrier in the ongoing campaign to improve access to health care for children in Medicaid. Pediatricians are left with fewer and fewer avenues to improve access for children by advocating on the issue of inappropriately low Medicaid payments.

“Medicaid matters for children. More than 44 million children—37 percent—across the country rely on Medicaid or the Children’s Health Insurance Program (CHIP) to finance their care, whether for diagnosis and treatment of illnesses and chronic diseases, or preventive care services like immunizations and check-ups.

“Historically, Medicaid payment rates have been very low compared to Medicare and commercial insurance rates. On average, a pediatrician treating a child on Medicaid is paid about two-thirds of what is paid by Medicare for the same service or treatment, and half of what private insurance pays. This payment prevents pediatricians from increasing access for children who need care under Medicaid.

“Every child needs access to affordable, quality health insurance, and pediatricians view today’s decision as a step backward in ensuring this basic foundation of health is met for every child. The American Academy of Pediatrics (AAP) will continue to advocate for Medicaid payment equity at both the state and federal level to ensure vulnerable children and families can access the care they need, when they need it. Our children deserve better.”


The American Academy of Pediatrics is an organization of 62,000 primary care pediatricians, pediatric medical subspecialists and pediatric surgical specialists dedicated to the health, safety and well-being of infants, children, adolescents and young adults. For more information, visit and follow us on Twitter @AmerAcadPeds.

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