Stop Picking On Our Most Vulnerable Children

It is unfathomable to me that week after week I must continue to defend the Medicaid program that for more than 50 years has protected the health and well-being of tens of millions of America’s most vulnerable.

According to koodakpress، We know many of the 37 million children enrolled in Medicaid today are from poor or low-income families and that 40 percent of children with special health care needs benefit from Medicaid. Among these children are almost half a million foster children, nearly 40 percent of them under age 6.


These children, invisible to many, are the most vulnerable of the vulnerable. Most have been abused or neglected, removed from their families and placed in foster care — either a family foster home, group home or child care institution — clinging to hopes of returning to their families or finding a new permanent family through adoption or with a relative guardian. A growing number today are children of parents struggling with opioid addiction or other mental health challenges.


Fortunately, foster children who suffer from physical and mental health conditions at much higher rates than their peers who are not in foster care are eligible for Medicaid to help put them on the path to success. But today Medicaid is facing the biggest threat in its over half a century history. The House of Representatives has voted to gut it and the Senate is poised to be equally cruel in the misnamed Better Care Reconciliation Act, jeopardizing the health and futures of millions of vulnerable children and families who have counted on Medicaid.


Virtually all children in foster care have suffered trauma in their lives and have greater health and mental health needs than children not in care. A study by the American Academy of Pediatrics finds children in foster care are twice as likely as their non-foster care peers to have developmental delays, asthma and obesity; are three times more likely to have ADD/ADHD, hearing problems and vision problems; are five times more likely to have anxiety; are six times more likely to have behavioral problems; and are seven times more likely to suffer from depression. Not only does Medicaid ensure foster children access to basic health care but it gives child welfare agencies the opportunity to connect children to the critical behavioral health services and treatment they need to build a healthier future and enable them to live independently and contribute to society. Foster children represent 29 percent of Medicaid expenditures for children’s behavioral health services.


Jack and Linda Quirk became foster and then adoptive parents in California for Marissa, now 15; Reuben, 14; and Anna, 10, after their biological children went off to college. All three suffer from fetal alcohol spectrum disorders and intellectual and behavioral health challenges requiring extensive care. Reuben, who is on the autism spectrum, has severe behavioral control problems related to attachment disorder and fetal alcohol exposure and is often uncontrollably violent. The family has moved to Illinois to be near a specialized residential facility to remain close to Reuben as he receives needed care. Without Medicaid the Quirks could not have afforded their adopted children’s extensive specialized care and all three would almost certainly have been in more expensive long-term group care instead of a loving family.


Medicaid also helps keep children out of foster care by getting parents the treatment and services they need before they come to the attention of the child welfare system. The expansion of Medicaid to 11 million low-income adults in the Affordable Care Act gave many parents and other caregivers — some of them for the very first time — much-needed access to services to address problems that otherwise might have resulted in removal of children from their care.


Once children are in foster care, Medicaid helps child welfare agencies secure the funding necessary to offer mental health, substance abuse and other specialized treatment to parents to help stabilize families and return children home safely. Medicaid also helps place nurses and other health specialists inside child welfare agencies.


Without Medicaid to address the special needs of our vulnerable children placed in foster care, children are likely to stay longer in care, to be removed from families who can no longer meet their special needs, and to be placed in more restrictive and costly institutional settings at state expense. Although foster care is supposed to be temporary, the average length of stay is nearly two years. For more than 30 years, many of the children with special needs who exit foster care to adoptive families have been able to continue to receive Medicaid to help their new permanent families care for them.


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