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Journal Issue: Children and Divorce Volume 4 Number 1 Spring/Summer 1994

REVISITING THE ISSUES: Children and National Health Care Reform
Sara Rosenbaum

Treatment of Medicaid

The bills vary greatly in their treatment of Medicaid, the nation's largest source of public health funding for children. The Cooper/Breaux and McDermott/Wellstone bills eliminate Medicaid entirely. The Cooper/Breaux bill makes states solely responsible for those items and services currently provided by Medicaid but not included in the guaranteed benefit package.

The President's bill eliminates Medicaid for services that would be covered by beneficiaries' health insurance plans. It leaves in place those current Medicaid benefits that would not be covered by the comprehensive benefit package. Thus, all treatment services would continue to be covered for low-income children through both the basic Medicaid plan and through a special new "children's wrap-around" program that would be federally administered and subject to uniform national rules.

The Thomas/Chafee, Michel/Lott, and Stearns/Nickles proposals all maintain separate Medicaid programs for eligible low-income persons through which both basic and long-term benefits would be provided. At their option, states could replace Medicaid with private coverage. Under these bills, children receiving public assistance potentially would remain covered by Medicaid while other low-income children would receive coverage through private plans.