Hearing of the Health Subcommittee of the House Energy and Commerce Committee - Examining the Advancing Care for Exceptional Kids Act

Hearing

Mr. Chairman, thank you for holding this hearing, and thank you to our witnesses for being here. Few programs are as critical to the well-being of our nation's citizens as Medicaid. For over 50 years, the Medicaid program has provided comprehensive healthcare coverage to America's most vulnerable populations. While our hearing today is specifically about medically-complex children in Medicaid, I urge my colleagues not to forget the important role that Medicaid plays broadly for children in this country: Medicaid finances more than 50 percent of all births in this country, and provides more than 1 in 3 children with the chance at a healthy start in life. In 2015, the Medicaid and CHIP programs together covered more than 45 million children.

Children with complex medical needs includes a very special subset of children in the Medicaid program. These children typically have chronic multi-system diseases and demand intensive care. That is why Medicaid is particularly crucial for their families: Under Medicaid and CHIP, children with complex medical conditions receive a broad set of services that in many instances private insurance won't cover. It is not an overstatement to say that Medicaid is life-saving to these children, and provides a financial lifeline for their families that struggle with insurmountable medical expenses.

However, families and stakeholders agree that there are several issues related to treatment for this population that must be addressed. For example, many children with complex medical conditions travel nationwide for care, and report significant difficulty coordinating care across state lines and across many state Medicaid programs. They need care that is family-centered, and is based on comprehensive quality data that is simply not available nationally for this specialized population in Medicaid.

H.R. 546, the "Advancing Care for Exceptional Kids Act", also known as the "ACE Kids Act", aims to address these shortfalls. The revised discussion draft being examined today tries to incorporate some of the feedback we've received to date from stakeholders. The new draft gives states the option to establish health homes geared toward the treatment of children with complex medical conditions and includes two years of enhanced payments to states to help with implementation. The draft also requires increased quality reporting, transparency regarding payment across state lines, and guidance from the Centers for Medicare and Medicaid Services to states on best practices for payments across state lines.

I'd like to thank my colleagues Representatives Castor and Barton for championing this legislation for many Congresses and building extensive bipartisan support for such an important issue. The discussion draft under consideration is just that: a draft for discussion. I look forward to comments from stakeholders, including our witnesses today, and I hope that we can continue working in a bipartisan fashion moving forward to take a positive step forward for medically-complex kids in the Medicaid program. Most importantly, I'm glad we share the common goal of ensuring that these children receive the best possible treatment.

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