The policy statement calls for all state Medicaid agencies to cover the care outlined in Medicaid's Early and Periodic Screening, Diagnosis, and Treatment health benefit program; to provide broad pharmacy benefits; to ensure timely access to subspecialists; to ensure care without disruption for youths transitioning to adult care; and to develop and implement a pediatric medical home model.
The policy statement also includes suggested payment reforms. The AAP noted how low Medicaid payments have led to barriers to care and, because of that, the AAP argued that the safety net program's intent “to provide truly equal access to quality primary care and subspecialty care has not been fulfilled.” Suggested reforms include increasing payments for pediatric-specific services and rewarding practices that meet or exceed AAP-defined quality measures.
The AAP also voiced its opposition to convert Medicaid to a block grant program.
“Block grant proposals typically result in cost shifting from federal to state budgets and do not reduce overall health costs or improve quality of care,” the AAP stated.
So far, governors in 25 states have advocated for Medicaid expansion, and the AAP stated that it endorses the Affordable Care Act's provision to expand coverage to include children in families with an income below 138% of the federal poverty level.
“To date, governmental health policy on both state and federal levels has not adequately met the medical, behavioral and developmental needs of children,” the AAP stated, adding that implementation of the Affordable Care Act has the promise to change this and enrich pediatricians' “ability to provide the quality of car to which we aspire.”