Investing in Children When It Matters Most: The First 1000 Days on Medicaid

PreschoolersGuest post by Ben Anderson, Director of Health Policy at Children’s Defense Fund-New York. The New York State Department of Health (SDOH) is embarking on a “First 1000 Days on Medicaid” initiative that aims to bring together a diverse group of stakeholders from across sectors that touch the lives of young children. The stakeholders include representatives from a range of fields from the health care to post-secondary education to child welfare. The charge of the initiative is to produce recommendations for a ten-point plan that focuses on improving outcomes and access to services during the first three years of life.

The initiative arises from advances in neuroscience which tell us that most of the basic architecture in the brain is built by the time a child reaches the age of three. This basic architecture serves as the scaffolding upon which all future learning is built. Healthy physical and emotional experiences during these early years help form connections in the brain to facilitate future growth in cognitive, emotional, and social skills. Conversely, negative experiences impede the development of these connections, which make developing cognitive, emotional, and social skills more difficult.

Research from the Institute for Social and Economic Development (ISED) show that exposure to six or more risk factors prior to the age of three results in a greater than 90 percent chance of developmental delays (Barth et al. 2008). Risk factors include poverty, poor parental mental health, parental substance use disorders, domestic violence, and certain medical conditions. Additional research links adverse childhood experiences to increased risk for diabetes, heart disease, and cancer (Dong et al. 2004). Accordingly, what happens in the earliest years of life impacts lifelong well-being.

Medicaid is uniquely positioned to address these issues because the program serves many of the children who face the greatest risks for poor health outcomes (Halfon et al 2014). In New York, 59% of children in their first 1000 days of life depend on Medicaid. Developmental screenings and many early intervention services for children with developmental delays are currently covered by Medicaid. Primary care physicians who identify risk factors or developmental delays during regular check-ups are often the first point of contact and serve an important function by referring children and families to resources in the community to address the concerns.

The First 1000 Days on Medicaid initiative will convene stakeholders several times between now and November 1 to develop their recommendations. Subsequently, DOH will release its ten-point plan. HCFANY looks forward to working with the Department on this critical venture that has the promise to change the trajectories of our youngest New Yorkers.

Yay BlogAccording to an analysis from the Georgetown University Health Policy Institute’s Center for Children and Families and the American Academy of Pediatrics, a historic high of 98 percent of children in New York have health insurance. This is thanks in large part to New York’s progressive policies on Medicaid, Child Health Plus (CHP), and the Affordable Care Act (ACA).

Medicaid and CHP together cover more than 2.8 million children in New York State and account for 38 percent of the state’s total Medicaid and CHP enrollment. This includes 84 percent of children living in or near poverty, 47 percent of infants, toddlers, and pre-schoolers, 39 percent of children with special health care needs, 51 percent of newborns, and 100 percent of children in foster care. An additional 11,000 children in New York have coverage through the New York State of Health Marketplace. Because of New York’s leadership in health care and health coverage, all children are eligible for health insurance regardless of immigration status.

Children enrolled in Medicaid and CHP do better in school, are more likely to graduate from high school, are more likely to attend college, grow up to be healthier adults, and earn higher wages. Continued investment in Medicaid and CHP and outreach to the remaining uninsured is needed to ensure that all of New York’s children and families have the opportunity to reach their full potential. This is especially important in the face of the current federal threats to these crucial sources of coverage.

You can view the full New York State fact sheet here.

highfive-01-800pxLast night, Senate Republicans failed in their last ditch effort to repeal the ACA and dismantle Medicaid. A huge thank you to our members, partners, and friends for all of your hard work and activism over the last nine months.

Your resistance is the reason they keep failing.

Unfortunately, the fight is not over. The President is still threatening to end Cost Sharing Reduction payments that reduce out of pocket costs for moderate income Americans and there is a House budget proposal that would cut trillions of dollars from Medicaid and other health care and entitlement programs over the next 10 years.

Seven of NY’s Representatives voted to pass an anti-health care bill in the House: Chris Collins, John Faso, Peter King, Tom Reed, Claudia Tenney, and Lee Zeldin. They may soon have another chance to decide our fate through the budget process – this Saturday, show them in person that those first votes were a mistake!

Here’s what you ca do to stay engaged:

  1. Join people across the country at demonstrations. We already know about events in places like BeaconKingstonDelhiNew HartfordNew York City, and Glens Falls. We’ll add events to our eventspage as soon as we learn about them so keep checking!
  2. You could also plan your own event! The Our Lives on the Linesite has some tools to help you do this, but all you really need to do is show up at your Representatives’ offices with signs or letters telling them not to support any bill that takes health care away from people.

We’ve come so far – and we won’t stop fighting now!

fingerpaintLast week, children’s health advocates from across the country came together in Washington, DC for the Georgetown University Health Policy Institute Center for Children and Families Annual Conference. The conference provides an excellent opportunity for national and state advocates to share their experiences and learn from one another, which is especially important in the face of the current federal threats to children’s health care.

This year’s conference theme was “Covering Kids and Families: Playing to Win.” Topics included the current political landscape, the future of the Medicaid and CHIP, value-based purchasing, and using effective messaging and social media to win the fight for children’s health coverage. We heard from experts in the field about the state of play in Washington, the impact of perception, race, and bias on Medicaid, expanding health coverage for immigrant children, and avenues for working together with early childhood and education advocates to protect children’s health.

HCFANY’s Children, Youth, and Families Task Force represented New York consumer advocates at the conference. HCFANY’s Kate Breslin, President and CEO of the Schuyler Center for Analysis and Advocacy, spoke on a panel that highlighted New York’s child-focused value-based purchasing (VBP) initiatives and opportunities for advocates in other states to engage in VBP for children.