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AAP Statement on Legislation to Extend the Medicaid Payment Increase

7/30/2014 By: James M. Perrin, MD, FAAP, president, American Academy of Pediatrics

"The American Academy of Pediatrics applauds U.S. Senators Sherrod Brown (D-Ohio) and Patty Murray (D-Wash.) for introducing legislation today that will improve access to care for millions of children from low-income families and with special health care needs. The bill, the Ensuring Access to Primary Care for Women & Children Act, funds appropriate payments for many Medicaid services for two additional years.

"Medicaid matters for children. In fact, children make up more than half of all Medicaid patients. Unlike private insurance coverage, which is designed around the health care needs of adults, Medicaid's benefits are developed for and designed to meet the unique growth and developmental needs of children, including early recognition of treatable conditions.

"Although pediatricians care for children covered by Medicaid, on average, they receive less than 70 percent of Medicare payment rates for providing identical services. For many services and in many states, payments can be even lower. Due to these low payment rates, pediatricians are not always able to accept new Medicaid patients, which creates an unnecessary barrier to care for children in the program.

"While federal law increased payment rates for many primary care services within Medicaid to at least those paid by Medicare for 2013 and 2014, the pace of implementation has varied from state to state. The legislation introduced today would allow for continued success where the increase has already taken hold, and offer states additional time where the payment increase is still underway. The Ensuring Access to Primary Care for Women & Children Act will also continue to apply the increased payment to services provided by many pediatric subspecialists, who treat especially vulnerable children in need of the most specialized care.

"Pediatricians welcome today's legislation as a much-needed step forward for children's health, and will continue to urge Congress to extend the Medicaid payment increase so that all children can receive the medical care they need, when they need it."

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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 www.aap.org and follow us on Twitter @AmerAcadPeds.

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