Using Children to Federalize Health Care?



February 18, 2015
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Beware the Advancing Care for Exceptional Kids Act of 2014. Proponents say the ACE Kids Act (H.R. 4930) will improve coordination of care for children with complex conditions on state government programs. Sponsored by Congressman Joe Barton (R- Texas), it has 48 Republican and 56 Democrat co-sponsors.

Unfortunately, this looks like a new federally controlled health care system. It is established in the states to provide both coverage and care in an “all-inclusive payment model.” (P. 14, Ln. 19) It reminds me of the state-established Obamacare exchanges, which are also federally-controlled.

The Act creates “nationally designated children’s hospital networks” (“Network”) for children eligible for government programs. An email from Barton’s office states: “this legislation would move beyond a state by state approach and creates a national framework for delivery system reform.”

Major concerns include:

·      Mandatory Enrollment: Creates a Medicaid Children’s Care Coordination (MCCC) program into which eligible children must be enrolled if states participate in the federal Network. (P. 4, Ln. 5)

·      No Consent: Children are assigned to a Network. (P. 5, Ln. 8) After 90 days a child can opt-out and enroll in traditional Medicaid (P. 6, Ln. 8)

·      Federal Intrusion: The Network must “submit care management network and coverage plans to the Secretary” of HHS (P. 7, Ln. 23) and give her access to “pertinent financial, medical and personnel records.” (P. 10, Ln. 19).

·      Federal Database: The Network must report coverage claims data “for purposes of establishing a national database on such claims.” (P. 10, Ln. 13)

·      Federal Oversight: The Network must submit to the Secretary data to “monitor the operation, cost, and effectiveness” of MCCC. (p. 10 – 11)

·      Doctors as Insurers: HHS will “transition from fee-for-service to [a] risk-based payment model,” which places doctors and hospitals at financial (insurance) risk through “value-based” payments.(P. 14, Ln. 1)

·      Wealth Redistribution: Payments use Obamacare’s ‘3R’ programs that redistribute dollars between health plans, based on which Networks can make their patients look the worst using data. (P. 15, Ln. 20)

·      Choice Limited: The requirement that Medicaid and CHIP enrollees have “freedom of choice of providers” is waived. (P. 16, Ln. 13)

·      State Law Invalidated: Anti-trust laws and any state laws contrary to establishment of the federal Network are waived. (p. 16 and 17)

What child could be placed into the Network? An eligible child is….

any child under the age of 18 who are eligible for Medicaid or CHIP and who “has, or is at a heightened risk of developing, a chronic, physical, developmental, behavioral, or emotions condition that (1) affects two or more body systems…”

I called Congressman Barton’s office. They expect the bill to move this year, but there’s no Senate bill yet. 

I’d be happy to be proven wrong, but I believe the ACE Kids Act further federalizes health care. Congressman Barton is probably trying to help parents and children having problems in public programs, but public programs are the problem. And whoever helped create this plan likely has national health care, not children, in mind. You might give him a call and let him know what you think: #202-225-2002.

Fighting national health care wherever it pops up,

Twila Brase, RN, PHN

President and Co-founder