As states reassess Medicaid coverage following recent federal policy changes and the end of pandemic-era protections, researchers are advocating for evidence-based health care policy reform and expanded Medicaid coverage for children.
Weill Cornell Medicine's Department of Pediatrics, the Cornell Health Policy Center (CHPC) and Ariadne Labs are collaborating to launch the Era of the Child Initiative, which supports the design and implementation of effective policies to improve U.S. children's health.
"We have joined forces because as a country we haven't prioritized children's health and the pediatric health care workforce enough," said Dr. Robert A. Harrington, the Stephen and Suzanne Weiss Dean of Weill Cornell Medicine. "U.S. children face rising rates of chronic conditions like obesity and diabetes, mental health issues and fatal injuries, and they have nearly double the death rate of children in other high-income countries."
Medicaid is a joint federal and state program that provides free or low-cost health coverage to millions of Americans with limited income and resources. Nearly half of America's kids, approximately 37 million children, depend on Medicaid for preventive and acute care, yet recent policy changes could undermine the resources essential to raising healthy children. Uninsured rates among children are expected to increase in coming years due to changes from the 2025 One Big Beautiful Bill Act (OBBBA) to the Medicaid program.
Research has shown that Medicaid coverage for kids leads to improved health, educational attainment, better labor force participation and higher income in later life. In addition, three-quarters of U.S. youth ages 17-24 are not eligible for military service due to poor health. Despite the long-term benefits, states are pressured by short fiscal budgets and political cycles, making it difficult to prioritize the investment.
As part of the Initiative to address these issues, a recent panel discussion in Uris Auditorium at Weill Cornell brought together experts in children's health care policy to discuss the challenges of revamping Medicaid to best meet the needs of children.
Moderator William Schpero, assistant professor of population health sciences at Weill Cornell and associate center director of CHPC, challenged the expert panel to focus on state-level innovation, bipartisan solutions and pioneering strategies to transform the health care system.
According to the panel, a major obstacle in providing insurance for all children is the funding constraints states operate under, including decreased federal funding.
"When advocating for Medicaid investment, we talk about the many valuable societal outcomes, in addition to the pediatric health outcomes," said Dr. Nivedita Mohanty, senior vice president for child health finance and quality at the American Academy of Pediatrics. "We support universal eligibility and continuous Medicaid coverage from when an infant leaves the hospital until they're 26 to prevent harms that occur when coverage is interrupted."
Together with funding these programs, identifying appropriate metrics to measure how well Medicaid is working will be necessary. The current quality measurement system could be improved by including metrics of broader societal benefits like school readiness and food security, which are not typically included, Mohanty said.
The panel suggested that harmonizing measures across states would allow more effective data analysis.
"I think we need to be bold in what we measure, and we need to hold people accountable, particularly the ones who hold the money, such as the state and managed care companies," said Dr. Mandy Cohen '00, a national adviser at Manatt Health and former director of the Centers for Disease Control and Prevention.
After the panel discussion, approximately 30 invited experts in the field met in a strategy session focused on reviewing recommendations developed by two working groups.
Dr. Beth McGinty, professor of population health sciences at Weill Cornell and co-founding director of the Cornell Health Policy Center, and Dr. Charlene Wong, associate professor in pediatrics at Duke University School of Medicine, led the working group focused on building a pediatric alternative payment model. Dr. Sallie Permar, chair of pediatrics at Weill Cornell, and Lindsey Vuolo, policy director at CHPC, led a working group on strengthening coverage and benefits for children in Medicaid.
Participants also discussed communication strategies for building support for changes to Medicaid and brainstormed how to create an ideal financing system to improve pediatric care access and quality.
Read the full version of this story on the Weill Cornell Medicine website.
Nadia Halim is science editor at Weill Cornell Medicine.
