Welcome
to the Children’s Medicaid Defense Project page
The Children's Medicaid Defense Project is seeking to establish a family action network to help with responding to issues that may come up with pending Medicaid cuts and to educate policymakers and other stakeholders on how essential Medicaid is to supporting wellness and family life for children with developmental disabilities and/or complex medical needs.
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For Family Members of Children with Developmental Disabilities and/or Complex Medical Needs
CHILDREN WITH DISABILITIES IMPACT ALERT!!
GOVERNMENT SHUTDOWN AND HEALTHCARE
October 2025
On October 1st, the federal government is set to shut down many of its operations due to the failure of Congress to pass a budget bill. The impasse is a result of a profoundly important dispute over the funding of healthcare. Republicans recently voted to cut hundreds of billions of dollars from the Medicaid Program, to end eligibility for many, and to end federal subsidies that currently make healthcare affordable for low- and middle-income families through the Healthcare Marketplace (Obamacare). Democrats are insisting that these programs be reinstated and funding be provided for them in any new budget. To learn more, click here.
CHILDREN WITH DISABILITIES IMPACT ALERT!!!
FEDERAL CUTS TO HEALTH INSURANCE PREMIUM SUBSIDIES MAY IMPAIR CHILDREN’S ACCESS TO CAREGIVERS
October 2025
Getting and keeping qualified caregivers is critical to keeping children with developmental and medical disabilities in a family home rather than an institution. Health insurance is critical to recruiting and keeping those caregivers. For many caregivers, their only option for health insurance is through the “Marketplace,” also known as Pennie or the Affordable Care Act/“Obamacare.” To make the premiums for health insurance under marketplace health plans affordable, the Affordable Care Act provides subsidies for the cost of those premiums for individuals with incomes below a certain level. However, one of the many changes in the recent federal budget act (the “One Big Beautiful Bill Act or “OBBBA”) is the reduction of some of those premium subsidies. Discussions are currently underway in Congress as part of the federal budget negotiations to restore those cuts to the marketplace insurance premium subsidies. To learn more, click here.
For more on the impact of expiring enhanced premium tax credits on ACA marketplace premiums, click here for an article from the Kaiser Family Foundation (KFF).
CHILDREN WITH DISABILITIES IMPACT ALERT
MEDICAID FUNDING IS PART OF STATE BUDGET IMPASSE
October 2025
The state constitution requires the PA legislature to pass a budget by July 1st of each year to fund state offices and programs for the next 12 months. It is now more than 120 days past the constitutionally mandated deadline but there is still no state budget for the current fiscal year. To learn more, click here.
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CHILDREN WITH DISABILITIES IMPACT ALERT!!!
CAREGIVERS WITH INSURANCE THROUGH PENNIE LIKELY TO SEE HIGHER PREMIUMS WHEN REENROLLING
November 2025
Reductions in subsidies for Pennie (Marketplace) premiums will go into effect January 2026 unless Congress acts, but reenrollment starts November 1st. As Congressional leaders have failed to take action, both professional and family caregivers on Pennie will soon be getting reenrollment notices with the higher premium rates.
For more information, see PHAN’s statement at https://www.pahealthaccess.org/news/phan-statement-on-2026-pennie-monthly-cost-increase/ and this article from Politico:
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November 2025
To read more, click here.
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CHILDREN WITH DISABILITIES IMPACT ALERT: CHILDREN’S BEHAVIORAL HEALTH SERVICES
November 2025
In Pennsylvania, Medicaid, also called Medical Assistance (or MA), pays for tens of thousands of children to receive needed behavioral health services at no cost to their parents, and often in their own homes, schools, and communities.
When behavioral health services are determined by a doctor and an MA health plan to be medically necessary, they may include outpatient therapy, in-home aides, behavior consultants, school or community aides, specialized autism treatment, medication management, residential treatment programs, acute care hospital stays, and more. The home and community-based services are called by different names, e.g., wraparound, Intensive Behavioral Health Services (IBHS), Applied Behavior Analysis (ABA), outpatient therapy, partial hospitalization, and so on.
If your child is receiving behavioral health services with no copayment or deductible, their services are most likely being funded, in full or in part, by Medicaid. Read more here.