“I don't see an upside to block grants,” panelist Jocelyn Guyer said after the discussion. “To me, they seem like they would be very destructive to kids' coverage. The basic point of them is to shift costs from the federal government to states, and I think we'd see enormous cutbacks across the board—especially if you look at the context in which we're talking about block grants, which is trying to save federal money.”
Guyer, co-executive director of the Center for Children and Families at Georgetown University's Health Policy Institute, said the block-grant issue is centrally important to children's coverage because more than one in four children in the U.S. relies on Medicaid for health insurance, and they also represent half of Medicaid enrollees. In its first report last month, the Medicaid and CHIP Payment and Access Commission, or MACPAC, reported that Medicaid finances healthcare and related services for more than 30 million low-income children.
During the panel discussion, Guyer said the percentage of uninsured kids was about 10% in 2009—the lowest uninsured rate since census data was first collected on uninsured children in 1987. She and fellow panelist Cathy Caldwell of the Alabama Public Health Department both emphasized the need to determine if more access has resulted in effective care. MACPAC will be a good source for this, according to Guyer and Vikki Wachino, director of the Children and Adults Health Programs Group in the CMS' Center for Medicaid, CHIP and Survey & Certification.
In her remarks, Wachino highlighted HHS Secretary Kathleen Sebelius' plan to enroll the 5 million uninsured children who are currently eligible for Medicaid or CHIP during the next five years. This figure takes into account immigration status, said Georgetown's Guyer, so it reflects those kids who are both documented and eligible for the federal program.