In July 2023, US Senators Michael Bennet (D-CO) and Chuck Grassley (R-IA), along with US Representatives Lori Trahan (D-MA) and Mariannette Miller-Meeks (R-IA), introduced legislation to improve access to critical care for children with complex medical conditions that may not be available in their home state. The Accelerating Kids’ Access to Care Act aims to eliminate regulatory barriers that pediatric patients face when traveling out of state for medical care.

More than half of the children in the United States rely on Medicaid for their health care coverage. Despite widespread enrollment, coverage is currently restricted to providers within the patient’s home state. Additionally, federal law mandates that all health care providers undergo a background screening before they can enroll in any state Medicaid program. While states are permitted to accept background screenings conducted by other states, there is no unified pathway allowing providers to complete a single screening and enroll in multiple state Medicaid programs. The current Medicaid provider enrollment system poses significant challenges for children’s access to specialized care not available in their home state.

Children with complex medical conditions and rare diseases sometimes need to travel out of state to receive necessary treatments. Yet, under the current requirements, these children frequently face treatment delays because their out-of-state health care providers must undergo the time-consuming process of screening and enrollment in the child’s home state Medicaid program. The process is full of redundancies; it consumes valuable provider time and resources, increases program costs for both providers and patients, and, most critically, delays children’s access to essential medical care. Sponsors of the Accelerating Kids’ Access to Care Act maintain that their bill would address these challenges by creating a novel, unified pathway, allowing pediatric providers to enroll in multiple state Medicaid programs through a single process, which they believe would reduce delays, lower costs, and expedite access to critical medical care for children.

The US House Energy and Commerce Committee unanimously passed the Accelerating Kids’ Access to Care Act on June 12, moving it one step closer to becoming law. Typically, after a bill clears the committee, it proceeds to the floor for further consideration and debate. Given the non-controversial nature of this legislation, it may pass under “suspension of the rules,” a streamlined process for bills with broad support. However, it remains uncertain whether the bill will be placed on the House floor calendar for consideration or if it will find another legislative vehicle for passage.

In the US Senate, the bill is pending in the Finance Committee and gained momentum in February after a 12-year-old brain tumor survivor testified about the challenges families on Medicaid face when seeking treatment across state lines. This heartfelt testimony has drawn considerable attention to the bill and its potential to effect positive change for children on Medicaid in need of specialized care. Despite this, there is no indication of a committee markup.

The Accelerating Kids’ Access to Care Act represents a vital step toward ensuring that children on Medicaid receive the essential medical care they need without facing unnecessary barriers based on their state of residence. By addressing these systemic issues, this legislation will provide timely and effective health care solutions for some of the most vulnerable pediatric patients in the nation.