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Advancing Care for Exceptional Kids Act of 2015
Great Seal of the United States
Long titleTo amend titles XIX and XXI of the Social Security Act to provide States with the option of providing services to children with medically complex conditions under the Medicaid program and Children’s Health Insurance Program through a care coordination program focused on improving health outcomes for children with medically complex conditions and lowering costs, and for other purposes.
Acronyms (colloquial)ACE Kids Act
Announced inthe 114th United States Congress
Sponsored bySen. Chuck Grassley (R, IA), Rep. Joe Barton (R, TX)
Codification
Acts affectedTitles XIX and XXI of the Social Security Act
Legislative history

The Advancing Care for Exceptional Kids Act of 2015 (S. 298, H.R. 546) is proposed legislation to amend Medicaid and the Children's Health Insurance Program of the Social Security Act to allow each state, at its option, to elect to provide medical assistance for items and services furnished to eligible children with medically complex conditions enrolled in a Medicaid Children's Care Coordination (MCCC) program.[1]

H.R. 4930, a different bill with the same name and similar provisions, was introduced in the 113th Congress and was cosponsored by 116 members of Congress (53 Republicans, 63 Democrats), but was never brought up for vote.

Background

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According to media coverage of the bill introduction, the ACE Kids Act "seeks to reduce problems that beneficiaries of Medicaid and the Children's Health Insurance Program—such as children with complex illnesses and disorders like leukemia and muscular dystrophy—sometimes encounter when they seek access to care across state lines. Since Medicaid and CHIP are state-based programs, non-emergency procedures tend to only be covered if they are provided within the state."[2]

U.S. Rep. Jaime Herrera-Beutler (R, WA), one of the bill's original cosponsors, notes that "the ACE Kids Act would create networks anchored by children’s hospitals to help coordinate care. States would choose to opt into this network, allowing families to seamlessly pursue the best doctors and facilities — even if it takes them to another state."[3]

Coverage of the original proposed legislation (H.R. 4930), adds that "each state-run [Medicaid] program has a different benefit package, payment structure and provider network. Conflicting regulations and paperwork requirements can delay treatment and lead to unnecessary hospitalizations. Medicaid’s state-based rules also have thwarted efforts to develop a national clinical database researchers could use to find ways to improve the care of children with rare diseases."[4]

There are an estimated 2 million children with medical complexity on Medicaid; these children represent 6 percent of all children in Medicaid, but 40 percent of all Medicaid spending on children.[4][5]

The bill has not been scored for costs by the Congressional Budget Office, but supporters claim it would save an estimated $13 billion over 10 years. Savings would be achieved through improved care coordination of services for the child to help streamline care and shift treatment away from emergency rooms and hospitals and into home care and outpatient clinics.[2][3][4]

Debate and discussion

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Families of children with complex medical conditions in Medicaid have been active in sharing their stories publicly and with members of Congress to advocate support for the bill. Visible advocates for the ACE Kids Act include Dr. Jen Arnold, co-star of TLC's reality series The Little Couple, who has met with members of Congress and appeared on television to discuss the legislation[6][7]; U.S. Rep. Jaime Herrera-Beutler (R, WA), a cosponsor of the bill and the mother of a children with complex conditions[3]; and Anthony Putney, a member of the military and father of a child with multiple complex conditions, who shared his family story at length in an essay for the peer-reviewed health care journal Health Affairs.[8]

Rep. Joe Barton (R, TX), sponsor of the House bill, notes that "over 60 of the nation’s leading children’s hospitals and numerous provider and patient groups have endorsed this legislation," but--other than the Children's Hospital Association--the specific provider and patient groups are not noted.[9]

Opposition to the bill has come from a trade group representing Medicaid health plans that contends that implementation of the bill would add costs, not create savings and would increase fragmentation, not coordination. Supporters of the bill disagree, taking issue with the lack of evidence offered by the opposition and noting that the financial estimates underlying the bill were actuarially validated.[10]

The bill is considered bipartisan.[9][10]

See also

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Notes and references

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  1. ^ "S. 298 Summary". Library of Congress. Retrieved 18 September 2015.
  2. ^ a b "Bipartisan bills would let severely ill Medicaid kids get out-of-state care". Modern Healthcare. Retrieved 18 September 2015. {{cite web}}: Check |url= value (help)
  3. ^ a b c "Herrera Beutler: An ACE in the hole for medically complex kids". The Columbian. Retrieved 18 September 2015.
  4. ^ a b c "Improving Medicaid for 'Medically Complex' Kids". PEW Stateline. Retrieved 18 September 2015.
  5. ^ "Finding a Formula for 'Medically Complex' Kids". PEW Stateline. Retrieved 18 September 2015.
  6. ^ "TLC's 'Little Couple' on big D.C. adventure". The Washington Post. Retrieved 18 September 2015.
  7. ^ "Season Premiere of TLC's The Little Couple Features the Introduction of Legislation". Children's Hospital Association. Retrieved 18 September 2015.
  8. ^ "Across State Lines, A Family Navigates Medical Complexity And Medicaid Hurdles". Health Affairs. Retrieved 18 September 2015.
  9. ^ a b "Bipartisan, Bicameral Group of Lawmakers Introduce Bill to Help Kids with Complex Medical Conditions". Congressman Barton Press Office. Retrieved 18 September 2015.
  10. ^ a b "Private Medicaid plans say interstate coverage for kids costs more, not less". Modern Healthcare. Retrieved 18 September 2015.
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Public Domain This article incorporates public domain material from websites or documents of the United States Government.


Category:United States federal health legislation Category:114th United States Congress

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