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Mr:dicaid is thr: largest clrileJrr-:n's health prr--rgrirm in ihe


country. It is aisc'r thet primary s{_lrt rce erf he_.alth caret for
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I olv-i u conr et fa m il ies ;: n ci..'l.l c'rlv a u ri
tl i s,:r Lr I ciJ peopl e.

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* Medicaid is a joint program rvith r:osts slrirred by both thc
fcdetral and staiet Ei{)l,cfltr1tctlts, while Mr:djcrrrt: is pald for
e-.uLir:e:lv by lhe federal goverrrn"lerrt.
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N4cclicaid nrainIy serves Iort'incclme families, rvhile


h,feclicare clrvers elderly and ciisabled people r,vho receirze
Tfu
Social Securitlr, regardless of their income.

l\4eclii:aicl aiso covr:rs rnany servict:s for Iorv-incoh.l{:}


eiderlv and disabled pe,'oplr:, r,r'lrich Mr,:djcart: docs nrit
pav for. Eoth proglanls arel irrdividual entitk:mclrts, lvhich
means that you clualify if you meret certairr criteria.

LJncler: broad feclt'ral gr,ridr'lines, r:ach state establishes its


ollin stanciards for Medicaid eligibiiitli benefits package I -
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and plovicier payment rates, alfhough the states mrist ilr ilit +;
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rneet certain rninirnurn standarclg and benefits.

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Bv far tlre nation's largest public provider of
childrerr"r's health insurance, Medicaid is a ; '

critic'rl health care safetv net for: millions of


lolr'-iucome children. It covers servicr:s
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identified as "nrecl ically l"lecessar'\i" inciudins
phvsiciar and hospitai visits, r,tell-chilcl
care, healtl"r screeuings, r,ision carc-' ancl
ilental serr.,ices. Without Meclicaid, rnost
if nol all of these chilc{reu rvolrlcl have
-rro health insurance.
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nrany sc'rvices i1lrd in many statc$, levr:i, paynrcrlt rates coulcl clecreast'-
payment can bel i:veltr lor.rrcr. Soulh fr,rrther. Mcclicaici must L-re prritr'-ctcd
Carolirrt-i Mi:clicaid pavri 1ee$ than to cnsllr:e chilciren's hospitals can
Mcciicarc rralue for tll'cr
bgtt',t tsi tlrer continric to provide qualitrlr healtlr
tl,:,| t.:t'; onei-thircl of the most corllltron carc til ;rll chlldren.
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pedia tric $crl'icrcs. Withou t c(r1sistc'nt
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p.r1'mcntr. fcrr er ph1'sici.rrti tt t.tv llt,|l,,,::l{l,tt{.lt:i|t1"{,i,:!:tstzu,F&*,{l;ii::ixi'i1
Children makr Lrp 527'1, i:rf Sotri:h berable tr participate in Medir:aid, **,& r* {} :n'f ?2/-???
Carolirra's Nledicai d poplll ation,
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thrcateni.ng r:hildren's access t0


br"rt are: ol very lctr,r' cost, accounting Medicaid face:s serious 1'inancial
quality health cai:e.
iol onlr,' 24:)i, of the state's Medicaid threals thal endanger the health
spenciing. ln gerlerai, South Carolina of Soutlr Carolina's children. An
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est i rrr ated t)2,625 Sou {.h Ca lr.rl na
ctrrildrei"r t{,ho are in families of 'ii'{,.,, "1;,,
1 i

four rvith inc'lrres belor't' $30,000


: := ::27?ll,lrrlr,0..:::-: :;:;j-';.-,;lrI I clrildren **-9.5')i, of Sorrth Carr:lina
are eligible for h4eclic"ricl."' Each
"1,1,";.. :::.1i;ai11 clrildrr,:n ;lre ulrinsur€)d. Forty-
- of llrerse: nninsured
eight per:cerri
b,teclicaid-el igilrle chihl costs Soutl"I Committec{ to serving all chilciten
C;rrr:llina $1,71t) per veat on a\rerage/ rt'garcik'ss tif alrilify to pav, r"lrilrllt'rr's children are eligible, bul rrclt enrolled
comparcd to the average costs per hospitals are essential to tlre health in lvfedicaid or the State Childrr:u's
aduh Medicaiil enrolleE: of $5,801 . of all children, espc'cially loilr- I{ealth Inslrrance lrrogram.
incosre clrildren. Less than 5?a of
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the nation's hospitals, cliildlen's tf N,fedicaid fr-rr-rcling is cr-rt or
hospitals provide aborrt 4{11)i of aLl cappec{, the nr,rmber of uninsurecl
tt:.a. ;:l;"1hll!'.' ,z r':r :'tzi' ::
inpatierrt hospital carc for chilclren children rvi1l grr:r,r' dramatically arrc{
I''edia triciar-rs provide a nr ajorit-v
on l.4r:dicaid and ahrlo-qt all the r:r:uld mean a loss of fecleral funcls
of all office rrisits to children ,-rrr hospital carc rc:cluirerd by r:hildren for 1'our state. Sincer the fecleral
\,leeticaic{. T[e1' provic{e the c;rle n'ith complcx conditi0t1s. And, government pays at letrst 69.5,qi' of
child rern 11eed, incltlci ing rou ti tre
ol-r avr.ll'age, each dr,.votecl half its the total cost of Suuth Carolina's
check-ups, intntutrizations and inpatient care (507L r.rf inpatient da,vs) Medjcaid program, thr: state lvill
tl'eatr-rrent for problems founc{ tr: childlen a$sistccl by &{cciir:aic{. loser $2.28 in iccleral matching funds
ei ulirrg htaltlr sct'eertinlis. for <:vely $1 in state money il cuts
Meclicaid paymerlts to children's fror:r its lr4edictrici br"r clget.
LJu for1.u na tel,r., Iow h'fed icaid
hospitals ;:re already lclr', covering
paynrcrrt raies placi,l att uultair onlv about 79?i, ol r.vhat provic{ing
burdcu onthilclrerr's pror.idcrs, care actu;rlly costs. lf cuts or caps '" Tn*rme r:llgibility diita jnclu.lc \{cclicaid
vvhich in turrr ccln put a bur:clen are actopted at ihe': federal or state expansions arrd cover drilclrtrr vtunger ihan'l'j.
on chilcl:ren and their families. For
examp:le, h.'ledicaid payment for
'' pt'tl i.ririci.ttts' sertict's is r ct'v pecr1'.
As a national averatr';c, lvfedicaid
pays onlv 70t)i, of thc h4edicare
value frlr pediatric sen'ices. For

For rnors information regarding


Medicaid and its impofianc€ t0
children in yoltr state, contact
f.l.A.C.i'|. 0r the American Academy
,H
of PodiFtrics.

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