New Jersey Children with Medicaid Struggle to Get the Care They Need

Take action! Write the New Jersey Legislature and Governor Murphy to ensure that every child, whether privately insured or relying on Medicaid, has access to the medical care they need.

Right now, thousands of New Jersey’s kids are struggling to access the comprehensive and integrated pediatric care they need. Many of these children have complex or rare medical conditions. Many others just need a specialist close to home.

This applies to all children whose health coverage is through a NJ Medicaid managed care plan. At the current time, there is no NJ Managed Medicaid health plan with Children’s Hospital of Philadelphia (CHOP) in its network. While some of these children might ultimately receive approval for the specialized care CHOP provides, the process for obtaining this approval is challenging, especially for vulnerable populations, and places hurdles between children and the care their providers know they need. We believe that physicians should be able to refer families to pediatric specialty care, and children should be able to receive that care, based on the type and level of care a child needs, not based on the form of insurance a child has.

There should be no barriers to children getting necessary care, regardless of income. For that reason, we have aggressively pursued in-network agreements with every NJ Medicaid managed care plan. At this moment, no NJ Medicaid plan has CHOP in-network.

What CHOP is doing to help children

At CHOP, in addition to continuing our push to be in-network with NJ Medicaid plans, our Government Affairs team and many teams across the CHOP Care Network are working together to find other solutions for these New Jersey families. We are advocating for a legislative solution to ensure that all of New Jersey’s kids who have Medicaid managed health plans have in-network access to pediatric specialists within easy distance of their homes. This will help all of these kids, and especially those with complex or rare conditions, by ensuring they can more easily get care without burdensome travel. We hope it will enable CHOP to be in plan networks, enabling these children to access CHOP without unnecessary barriers, but what matters most is that kids get the care they need without unnecessary hurdles.

What you can do to help

The Assembly Human Services Committee unanimously passed this legislation, Senate Bill 3000 and Assembly Bill 4688, at a hearing on Monday, June 14.

This legislation now needs a full vote by the end of the month to get Medicaid kids access to the care they need.

Write the New Jersey Legislature and Governor Murphy to ensure that every child, whether privately insured or relying on Medicaid, has access to the medical care they need.

For more information about this important initiative, please reach out to CHOP’s Government Affairs Department at GOVTAffairs@chop.edu.

Thank you so much for your time and support. Please know every message counts.


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