Virginia

Health care coverage is important for children because it improves access to pediatrician-recommended care and services that support healthy development. When children get the health care they need, they are more likely to succeed in school, graduate from high school and attend college, earn higher wages, and grow up into healthy adults. Scroll down for an in-depth look at child health care trends in this state.

Medicaid is a primary source of health insurance for children, providing guaranteed coverage, pediatrician recommended services, and premium and cost-sharing protections. Each state has the flexibility to design its program within federal guidelines as a condition of federal matching funds. The Children’s Health Insurance Program (CHIP) builds on Medicaid to cover children in working families who are not eligible for Medicaid but cannot afford private coverage. Each state designs its program within federal parameters (and can expand Medicaid and/or establish a separate state program) but all CHIP programs provide affordable coverage with pediatric-appropriate benefits and networks. Within Medicaid and CHIP, states have several policy options available to help remove barriers to health coverage and improve children’s enrollment and retention. Scroll down to see which policy options this state is leveraging to improve health coverage.

Medicaid has been successful in providing children with a usual source of care while significantly reducing unmet or delayed needs for medical care, dental care, and prescription drugs due to costs. Focus on improving the quality of care for children covered by Medicaid/CHIP is critical to eliminating health disparities and further boosting the broader, long-term impacts of public coverage on children as evidenced by studies showing that Medicaid leads to better health, higher educational achievement, and greater economic success later in life. As Medicaid increasingly turns to private managed care as the primary delivery system, measuring quality is a critical check on plan performance in providing required services and benefits. The Child Core Set, a set of standardized, evidence-based measures to assess the quality of care and health outcomes for children covered by Medicaid/CHIP, are an important tool for measuring how states are performing.  Reporting is currently voluntary for states, but reporting of these measures will be mandatory in 2024. Scroll down to learn more about how this state is performing on health care quality measures.

The health of children and pregnant women has been a long-standing national priority and Medicaid has been the primary means of backing up this commitment. A child’s brain develops most rapidly in the earliest months and years of life, building the foundation for future lifelong success. Healthy child development begins with healthy parents who have access to health coverage before, during and after a pregnancy. The bonds and relationships formed in the earliest years of a child’s life shape their early learning and development. Medicaid, along with CHIP, serves the vast majority of children in low-income families and covers about half of U.S. births each year. Scroll down to learn more about how this state is doing on child and maternal health care.