Bill Overview
Title: KIDS CARE Act
Description: This bill requires states to ensure eligible incarcerated juveniles are given health screenings and appropriate referrals under Medicaid and the Children's Health Insurance Program (CHIP) in coordination with their release. It also allows state Medicaid programs to cover juveniles who are pretrial detainees. The Centers for Medicare & Medicaid Services must also issue guidance on (1) ways to reduce administrative barriers for schools and school-based health centers to obtain reimbursement under Medicaid and CHIP; (2) how to expand mental, emotional, and behavioral health services under Medicaid; (3) existing Medicaid flexibilities to support children in crisis through more intensive services; and (4) strategies to increase access to telehealth services under Medicaid and CHIP.
Sponsors: Rep. Hudson, Richard [R-NC-8]
Target Audience
Population: Juveniles eligible for Medicaid being released from incarceration
Estimated Size: 45000
- The bill targets incarcerated juveniles who are eligible for Medicaid and are in the process of being released.
- This will directly affect children who are receiving Medicaid or CHIP benefits, streamlining their access to healthcare post-incarceration.
- Schools and school-based health centers will be impacted as the guidance will help them obtain reimbursements more efficiently, thus supporting more children.
- Approximately 2.7 million children in the U.S. have an incarcerated parent, but fewer apply to incarcerated juveniles targeted here.
- In 2019, the U.S. had an estimated 43,000 juveniles held in residential placement facilities at any given time. However, the number released annually is not exactly the same.
- An approximate global estimate might consider wider impact including families and support networks, but the specific focus on released juveniles reduces this.
Reasoning
- The KIDS CARES Act primarily targets an estimated 45,000 juveniles released annually from incarceration who are eligible for Medicaid. Thus, the primary focus is on these individuals and their access to healthcare upon release.
- The policy's budget allows for an average of roughly $2,000 per target child in the first year, scaling down as the program's structure becomes more efficient over time and as societal infrastructure improves.
- The policy is expected to have a subsequent positive impact on schools and school-based health centers through streamlined reimbursement processes, indirectly benefiting a broader range of children who utilize these centers.
- Several simulated interviews below reflect perspectives from the directly impacted group, school personnel, and peripheral societal impacts on families and communities.
Simulated Interviews
Student (Houston, Texas)
Age: 16 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- I really worry about what's gonna happen when I leave here. I don't know if I can keep getting help for my health. The news says this policy can help.
- If this policy helps get me the health checks I need and make it easier to see a doctor once I leave, it would be really helpful.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 6 |
| Year 20 | 9 | 6 |
Student (Los Angeles, California)
Age: 15 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- I need someone to help manage all my healthcare appointments and this policy says it might help.
- It would be great if I could stay healthy without feeling like it's a hassle to get care.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 7 | 5 |
| Year 20 | 8 | 6 |
Student (Chicago, Illinois)
Age: 17 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- The support has been irregular and stressful trying to get help from place to place. This policy could change that.
- If I had smoother access to health checks, it would ease some stress of trying to balance my life now.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 7 |
| Year 20 | 9 | 7 |
School Nurse (Miami, Florida)
Age: 32 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Our school could really benefit from easier reimbursement processes. We have so many kids who need help.
- This policy sounds like a move in the right direction but I worry about the practical implementation and any bureaucracy.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 8 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 8 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Social Worker (New York, New York)
Age: 40 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 8.0 years
Commonness: 5/20
Statement of Opinion:
- I've seen firsthand the struggle when kids transition out and lose access to care.
- The KIDS CARES Act sounds like a victory for us if it truly streamlines healthcare access.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 7 |
| Year 20 | 9 | 7 |
Juvenile Detention Officer (Riverside, California)
Age: 25 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 7/20
Statement of Opinion:
- With this bill, kids may find it a little easier when transitioning out, but it's just one part of a bigger problem.
- I'm concerned about the real-world logistics, but hopeful about what this policy means for the kids.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 6 |
| Year 5 | 8 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Student (Seattle, Washington)
Age: 14 | Gender: other
Wellbeing Before Policy: 3
Duration of Impact: 5.0 years
Commonness: 5/20
Statement of Opinion:
- Leaving here, feeling lost about healthcare and stuff is real. This policy might make it all a bit easier.
- Getting help without hitting walls sounds good, hope it actually works like that.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
Former juvenile detainee, current trainee (Atlanta, Georgia)
Age: 18 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 3.0 years
Commonness: 6/20
Statement of Opinion:
- Transition hasn't been smooth, healthcare is a hassle.
- If they really make it easier, policy could lighten the load for other kids going through what I did.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 6 |
| Year 10 | 8 | 6 |
| Year 20 | 8 | 6 |
School District Administrator (Detroit, Michigan)
Age: 45 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- This policy may streamline our processes, but I need to see how exactly this will be handled.
- It sounds positive, but often there's a gap between policy and practice.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 8 | 7 |
| Year 5 | 9 | 7 |
| Year 10 | 9 | 8 |
| Year 20 | 9 | 8 |
Pediatrician (Phoenix, Arizona)
Age: 50 | Gender: male
Wellbeing Before Policy: 8
Duration of Impact: 15.0 years
Commonness: 10/20
Statement of Opinion:
- It’s encouraging to see policy attempt to remove barriers to essential health resources.
- However, the efficacy depends on implementation – merely stating intent isn't enough.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 9 | 8 |
| Year 3 | 9 | 9 |
| Year 5 | 9 | 9 |
| Year 10 | 9 | 9 |
| Year 20 | 9 | 9 |
Cost Estimates
Year 1: $8000000 (Low: $6000000, High: $10000000)
Year 2: $8500000 (Low: $6500000, High: $10500000)
Year 3: $9000000 (Low: $7000000, High: $11000000)
Year 5: $9500000 (Low: $7500000, High: $11500000)
Year 10: $10000000 (Low: $8000000, High: $12000000)
Year 100: $11000000 (Low: $9000000, High: $13000000)
Key Considerations
- Administrative complexity of coordinating juvenile health rights with Medicaid is a key operational cost component.
- Potential overlaps with existing Medicaid/CHIP actions need clarification to avoid double-counting beneficiaries.
- Long-term behavioral and social impacts are uncertain but could enhance societal benefits beyond just fiscal measures.
- Effectiveness depends heavily on state implementation, which is variable.
- Cost estimations are sensitive to variations in release numbers and qualifying conditions.