While unmet need for HCBS for people with disabilities pre-dates the COVID-19 pandemic, the pandemic has brought a heightened focus on the need for additional HCBS. Medicaid is the primary payer for HCBS and plays a significant role in providing children with special health care needs the long-term services and supports (LTSS) they need to live at home with their families. Even though children with special health care needs covered by Medicaid/CHIP-only have greater health care needs, they are more likely than those with private insurance alone to report that their benefits are always adequate to meet their needs, allow them to see needed providers, and meet their behavioral health needs, reflecting Medicaid’s robust benefit package.While families of Medicaid/CHIP-only children with special health care needs are more likely to face financial difficulty, they find their health care more affordable than those with private insurance only due to Medicaid’s cost-sharing protections.Children with special health care needs covered by both Medicaid/CHIP and private insurance have the greatest health care needs, and children with Medicaid/CHIP only are more likely to have greater health needs compared to those with private insurance only. These children are more likely to be low-income, a member of a racial or ethnic minority group, and younger than those children covered by private insurance alone. children with special health care needs, though the share varies by state.
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