Page 78When it was enacted in 1965, Medicaid provided assistance to only the poorest of families who were receiving cash assistance. Over time, the public insurance program has broadened its scope of recipients to include low-income families and people of all ages with disabilities. Now, Children with Disabilities Medicaid Coverage allows families with children to participate in the Medicaid program by paying a monthly premium based on the family’s income.

The Early and Periodic Screening, Diagnostic and Treatment (ESPDT) benefit, which provides comprehensive and preventive health care services for children under 21, is a vital component of Medicaid that allows for the early diagnosis of disabilities and chronic illness in children, and treatment for those issues, before their conditions progress. In 1989 it became mandatory for states to provide medically necessary treatment even it the treatment was an optional service that the state had chosen not to provide for its Medicaid recipients in general. This is just one of the many actions Congress has taken to guarantee that children can access regular health services

In 1982 Congress passed the Tax Equity and Fiscal Responsibility Act, giving states the option to provide Medicaid benefits to children birth to age 18 who have medical, mental, and emotional health needs recognized by Social Security disability insurance, regardless of the family’s income. The act also provides a greater number of disabled children the access to Medicaid’s ESPDT benefit, central for diagnosing and treating childhood disease and illness.

National and state governments have worked to improve Medicaid services to millions of children with disabilities and chronic illness, recognizing that they require more frequent care and often have higher medical bills than the average patient.


New from Voices for Kids blog: Medicaid continues improving coverage for kids with disabilities.
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Want to learn more? First Focus is a bipartisan advocacy organization dedicated to making children and families the priority in federal policy and budget decisions. Read more about our work on child health.

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