Expanding Medicaid must be done with care

As the president of the Ohio Chapter American Academy of Pediatrics, I represent nearly 4,000 pediatricians throughout Ohio – reaching every corner of our state. As pediatricians, we support access to care for all children, and while expansion of Medicaid is a means to that end, it must be executed in conjunction with other elements of the federal Affordable Care Act (ACA).

The ACA included a temporary increase in Medicaid payment rates to at least those of Medicare for specialists, family practices and pediatricians. Recently, media reports have indicated that providers in our state are choosing not to accept Medicare patients due to the low profit margin of such patients. However, pediatricians throughout Ohio have been accepting Medicaid patients at rates well below those of Medicare for years and doing so at a loss. The temporary increase in our Medicaid reimbursement to Medicare rates included in the ACA will mean that we are able to expand access to care for more children.

While the American Academy of Pediatrics helped secure this two-year Medicaid payment increase, more work remains to be done to make sure Medicaid pays appropriately beyond 2014. We are supportive of Medicaid expansion, but we believe the temporary increase must be made permanent in order to ensure access to care in the long-term for all Ohio children.

Additionally, we support expansion on a philosophical level because it means more Ohioans will have access to needed care. Medicaid expansion means more adults will be covered under Medicaid, helping rural hospitals recover expenses related to care of these adults and leading to more stability in health care access in the most rural parts of our state. Additionally, we know that good quality health care prior to pregnancy is important to the health of developing babies. By providing Medicaid coverage to women in need before they become pregnant, we will be giving their children a healthier start.

Children’s health is an investment in primary prevention, addressing the development of disease at its earliest and most preventable stages. Medicaid expansion will help ensure access to care for those children who have no coverage right now and are falling through the cracks. Children are our future and our success as a state and as a nation is dependent on them. We must support their physical, cognitive and social-emotional health and development so that they may reach their potential. Access to high quality Pediatric care is a necessity for this to become a reality.

Judith T. Romano MD, FAAP, is president of the Ohio Chapter American Academy of Pediatrics.