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 4 |
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American assistance average babies benefits bills bronchopulmonary dysplasia catastrophic expenses 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 LIBRARY OF CONGRESS 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 spina bifida stay Susan Sullivan technology dependent children Thank therapy Total Number tracheostomy treatment uninsured ventilator waiver
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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 108 - About an equal number place similar limits on coverage of physicians' services. Others place strict limitations on such vital services as prescribed drugs and diagnostic services. o Finally, both Medicaid and private insurance frequently fail to cover extended home health and related services (including...
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 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...
Page 103 - ... coverage. As a result, lower income employees, faced with dramatic cost increases, have been forced to drop family coverage. Second, the employer insurance system also completely excludes millions families at the lower end of the wage of scale -- the fastest growing part of the job sector. Thirty percent of all employers who pay the minimum wage to more than half their work force offer no health insurance. ° As these young adult workers have families, the children are affected by their parents
Page 105 - Supplemental Security Income (SSI) are categorically excluded. For example, a family consisting of a full-time working father, mother, and two children normally is excluded from Medicaid even if the father is working at a minimum wage job with no health insurance and the family's income is well below the poverty line. Moreover, even though states have had the option since 1965 to cover all children living below state poverty levels regardless of family structure, as of December, 1986, 20 states still...
Page 106 - AFDC eligibilty levels. If fully implemented in every state, these amendments will reduce by 36 to 40 percent the number of uninsured pregnant women and young children nationwide. " However, even if fully implemented, these new laws will not compensate for Medicaid's growing failures. SOBRA's age limitations mean that Medicaid still will not reach low-income children over age five...
Page 257 - Health, the National Center for Health Statistics, and the National Center for Health Services Research and...
Page 264 - Approximately 220,000 premature babies are born each year- with intensive care nursery charges approximately $l,000/day, average hospital charges are over $35,000 for an immature infant - Heart surgery for a child may cost a family $22,000 for a hospital stay - Treatment for extensive burns may result in a hospital bill of $45,000...