Catastrophic Health Insurance: The Needs of Children : Joint Hearing Before the Subcommittee on Health and Long-Term Care of the Select Committee on Aging and the Select Committee on Children, Youth, and Families, House of Representatives, One Hundredth Congress, First Session, March 23, 1987, Volume 4United States. Congress. House. Select Committee on Aging. Subcommittee on Health and Long-Term Care U.S. Government Printing Office, 1987 - 293 pages |
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American assistance average babies benefits bills bronchopulmonary dysplasia catastrophic expenses cerebral palsy Chairman MILLER Chairman PEPPER CHAMPUS Child Health children with catastrophic Children's Hospital chronically ill child chronically ill children Committee covered Crippled Children's Services cystic fibrosis disabled children disease elderly eligibility employers expenditures federal funding going health care health insurance hearing hemophilia home health hospice care income infants institutional insurance companies insurance coverage intensive care unit interviewed limited live long-term Maternal and Child Medicaid medically fragile Medicare million months NACHRI National newborns nursing option out-of-pocket out-of-pocket expenses parents patients pediatric home physicians population private health insurance private insurance Project ABC RANDY KRAMER Reckeweg respiratory respiratory therapists respite respite care risk Senator social spina bifida stay Susan Sullivan technology dependent children Thank therapy Total Number tracheostomy treatment uninsured ventilator waiver
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Page 235 - State agency which is directly responsible for providing free public education for handicapped children (including mentally retarded, hard of hearing, deaf, speech impaired, visually handicapped, seriously emotionally disturbed, crippled, or other health impaired children who by reason thereof require special education...
Page 293 - Given the current conscientious debt-collection efforts made by hospitals, this $7.4 billion represents costs that patients could not pay, ie, clearly catastrophic costs. In short, while discussions of the catastrophic care problem frequently focus on the dramatic, relatively rare, acute care expenses of the elderly, the catastrophic care problem is much broader and much deeper, extending to both young and old, uninsured and insured.
Page 106 - This drop occurred despite the fact that Fiscal 1985 was the first year that the 1984 Deficit Reduction Act amendments were in effect, and it followed enactment by about a dozen states of additional optional Medicaid child coverage improvements. Finally, this decline occurred even though the number of children in poverty rose from 9.7 million to more than 12.5 million over the same time period. The primary causes of declining Medicaid coverage include stagnation in Medicaid's financial eligibility...
Page 289 - The inadequacy of Medicaid. Although Medicaid is often thought to be the principal means of financing care for the indigent, it now covers less than 40 percent of the poor. Medicaid must now be viewed principally as a program of supplementary coverage for the aged and disabled medically indigent who are eligible for and receive benefits under Medicare. In 1984, barely one-fourth of Medicaid's expenditures paid for care needed by the non-Medicare eligible poor. Three-quarters of Medicaid's expenditures...
Page 102 - Q the more than 9 million uninsured pregnant women, had family incomes below 200 percent of the federal poverty level. Poor and near-poor uninsured families, when confronted with even normal child health expenditures of several hundred dollars per year, face insurmountable health care barriers. As a result, uninsured low income children receive 40 percent less physician care and half as much hospital care as their insured counterparts.9 ."* • The uninsured are disproportionately likely to be children.
Page 101 - ... diseases including cystic fibrosis, spina bifida, leukemia, juvenile diabetes, chronic kidney disease, muscular dystrophy, hemophilia, cleft palate, sickle cell anemia, asthma, and cancer. Also included in this group are the several thousand children who are dependent on some form of life support system. Finally, nearly 7 percent of all infants are born at low birthweight (weighing less than 5.5 pounds) each year. Virtually all will require some additional medical services.
Page 106 - Act (SOBRA) passed in late 1986 permits states at their option to extend automatic Medicaid coverage to pregnant women and children under age five with incomes less than the federal poverty level but in excess of state AFDC eligibilty levels.
Page 105 - Medicaid, enacted in l965, is the nation's largest public health financing program for families with children. Unlike Medicare, which provides almost universal coverage of the elderly without regard to income, Medicaid is not a program of universal or broad coverage. Rather, it is based on need. Eligibility depends on having extremely low income. Because Medicaid is fundamentally an extension of America's patchwork of welfare programs, it makes coverage available primarily to families that receive...
Page 223 - ... health care, support, coordination, patient advocacy, and education to chronically ill children and their families. Home interviews were conducted by an independent research team with the 219 families at enrollment, 6 months, and 1 year; 80% completed all three interviews. Analyses indicate that pediatric home care is effective in improving the satisfaction of the family with care, in improving the child's psychological adjustment, and in lessening the psychiatric symptoms of the mother. The...
Page 10 - ... responding to a major health insurance survey conducted in 1986, 73 percent indicated that their Pla,ns exclude coverage of preexisting conditions. More plans now also contain riders that exclude coverage of certain conditions that may develop among enrollees, such as cancer. o Only about 75 percent of plans offered by medium and large-sized firms between 1980 and 1985 contained protections against huge out-of-pocket costs borne by enrollees in the event of catastrophic illness. o Only 67 percent...