As summer winds down and the start of a new school year draws near, pediatric practices in Nevada and the United States are bracing for a flood of incoming appointments. Anxious parents call to “seize” this necessary appointment so that their child(ren) can go to daycare, play a sport or go to school. Many of them hope to bring their child up to date on recommended and mandatory vaccines.
Over the years, pediatric practice staff have tried a variety of approaches to stagger appointments leading up to that inevitable back-to-school rush, including reminder calls, mailed postcards, and inducements to the practice. Pediatricians can better perform Early and Periodic Screening, Diagnosis and Treatment (EPSDT) exams and engage in patient education about missed vaccine doses when they are not overwhelmed by spikes in vaccine demand. patients.
What makes the back-to-school rush even more difficult is the large number of families who realize too late that their health insurance has expired. Many of us, at one time or another, have struggled with the paperwork required to maintain our health insurance. Nearly one in three Nevada children are covered by Medicaid, and they are at a particularly high risk of losing coverage due to churn. Churn is the temporary loss of coverage in which affiliates un-enroll and then re-enroll within a short period of time, primarily due to the nature of fluctuating low-wage income levels.
When the United States declared a public health emergency (PHE) for the COVID-19 pandemic in February 2020, it meant that children and families enrolled in Medicaid remained covered. This continuous coverage is one of the silver linings of the COVID-19 pandemic. For more than two years, no Nevada child on Medicaid has lost health insurance coverage or been denied access to a doctor.
Recently, the Center for Children and Families at Georgetown University released a report which found that millions of children are at risk of losing their medical coverage when PHE ends. The stability that has been given to children and families during the volatile time of the pandemic is set to end this year, and children in Nevada and five other states were identified in the report as being at higher risk of losing their Medicaid coverage. . Of particular concern to us is the possibility that a high percentage of children in Nevada who remain eligible for Medicaid coverage will lose it due to administrative and procedural hurdles – long wait times at call centers , undelivered mail and missing documents.
A longstanding solution to Medicaid churn is more robust funding for Nevada’s Medicaid programs. Other states have shown that funding parents and postpartum children for 12-month periods leads to more efficient health care, reduces the impact of inconsistent income on families, eases burden and costs and gives states better tools to hold health plans accountable for improving health outcomes equitably.
By reducing the administrative costs associated with cycling enrollments on and off Medicaid, states can spend more Medicaid dollars paying for quality healthcare at parity with Medicare, a policy that has been shown to increase access. children in care. The fight for continued coverage began long before the current pandemic and we will continue to advocate with state lawmakers until change is made permanent in Nevada.
The State of Nevada cannot keep children enrolled if they do not know where to send notifications and requests for information. As we work on our long-term solutions to combat churn, we urge parents in Nevada to take simple and immediate steps to avoid losing access to care by verifying their mailing address and other contact information with their health insurance company, as well as state access. Nevada website.
Vanessa Slots, MD, FAAP is president of the Nevada Chapter of the American Academy of Pediatrics. Tiffany Tyler-Garner, Ph.D., is the Executive Director of Children’s Advocacy Alliance.