In recent years, policymakers, health professionals, and parents have come to understand the significance of the first three years of life to a child's cognitive, social, and emotional development. A growing body of scientific literature, moreover, points to the long-term positive influence of key interventions during these early years-particularly for children from poor families. A new four-part report series from The Commonwealth Fund is looking at how federal and state health policy can help ensure that disadvantaged young children receive the preventive health and developmental services they need.
The first of these papers, Health Policy and Early Child Development: An Overview, looks at the connection between health policy and early childhood development. George Washington University analysts trace the evolution of federal health policy over the last 100 years pertaining to the financing and provision of preventive health services for young children. The report also provides a summary of statistics on health insurance coverage for young children as well as program-specific data.
In the second paper, Room to Grow: Promoting Child Development Through Medicaid and CHIP, the authors examine the current and potential role of Medicaid and the State Children's Health Insurance Program (CHIP) in delivering child development services to children under age 3. Together, Medicaid and CHIP form the largest combined source of child health financing in the United States. While they must meet certain federal financial standards, both offer states substantial flexibility in creating strong preventive pediatric services. Formal federal guidance on Medicaid and CHIP payment for child developmental services is sparse. Nevertheless, statutes, regulations, and earlier guidance from the federal Centers for Medicare and Medicaid Services underscore how much leeway states have to fashion a strong developmental component for their programs. States can, for example, establish eligibility rules and enrollment procedures that ensure children's access to care at the earliest possible time; define covered program benefits to include preventive health care related to child development; and incorporate financial incentives in provider compensation arrangements to reward the furnishing of developmental services.
The next two papers in this series will look at the potential of state Title V Maternal and Child Health programs and federally qualified community health centers to provide a full range of developmental services for children of low-income families.
Facts and Figures
- Twenty-three percent of insured children under age 6 (5.4 million) were covered by Medicaid in 2000.
- Nearly half (49%) of low-income insured children under age 6 (4.7 million) were covered by Medicaid in March 2000.
- States Medicaid agencies are able to define covered benefits to include developmental services; modify eligibility or enrollment procedures that would ensure access to preventive services; and use financial incentives to reward pediatric providers who offer this care.