Current Environment:

Federal policy

Child health coverage and access to care

Medicaid is the single largest health insurer for children — providing a comprehensive set of benefits to more than 40 percent of children nationwide and the majority of children with complex medical conditions. Children’s hospitals are major Medicaid providers, and the program is the largest payer of patient care in children’s hospitals. A strong Medicaid program is an important investment for children and the nation.

There are 2 million children with complex medical conditions in the U.S. They account for 6 percent of children on Medicaid and 40 percent of Medicaid costs. Under Medicaid, families of children with medical complexity struggle to coordinate their complex, multi-state care. Boston Children’s Hospital works closely with other children’s hospitals to advance federal legislation and regulations to ease these burdens, improve care, and reduce costs by organizing coordinated networks of providers focused on children with medical complexity.

Boston Children’s Hospital is committed to ensuring that children and adolescents have access to quality mental, emotional, and behavioral health care. This commitment has been intensified by the coronavirus pandemic, which has increased the need for a responsive behavioral health system and workforce. We are working to advocate for longer term investments in children’s mental health and well-being; and in the short term, focused on steps that we can take to better use existing provider capacity and tools, such as telehealth, to increase access and prevent children from needing to go to children’s hospital emergency departments for lack of available services in the community.

Children’s Hospital Graduate Medical Education Program

Congress enacted the Children’s Hospital Graduate Medical Education (CHGME) program in 1999 with the goal of providing freestanding children’s hospitals with the same support for training activities that other teaching hospitals receive through Medicare. This has enabled children’s hospitals like Boston Children’s Hospital to sustain and strengthen their teaching programs as well as continue to increase services dedicated to children’s unique health care needs.

In Fiscal Year 2021, Congress and the Administration provided $350 million for CHGME. While this represented an all-time funding high for the program, at this level CHGME support still only represents approximately half of the support Medicare GME provides on a per-resident basis. We are urging Congress to work diligently to close this gap; for Fiscal Year 2022, Boston Children’s and our peers are asking Congress to provide $485 million for the CHGME program.

Investments in pediatric research

Boston Children’s Hospital is represented on the steering committee of the Coalition for Pediatric Medical Research (CPMR), a collaboration of our nation’s leading children’s hospitals and related research institutions. Together with the CPMR, we are engaged in legislative and regulatory efforts to increase and better coordinate the National Institutes of Health funds that are dedicated to pediatric research and to strengthen the next generation of pediatric researchers.

If you are interested in getting more information on any of the following federal initiatives, please contact Amy Judge DeLong, Director of Federal and External Relations, at Amy.DeLong@childrens.harvard.edu or Alyce Norcross, Senior Government Relations Specialist, at Alyce.Norcross@childrens.harvard.edu.