Medicaid: Safety net and stepping stone

July 30, 2015 | (20) Comments

One out of every 10 children in the United States lives in Texas, and one in four of these children is likely to live in poverty. How many of those children go without health care because they are uninsured?

It’s a staggering concern and one we take to heart here at Texas Children’s. For me, regardless of my own political beliefs, when I hear these numbers, and I think about all the children and families who need our help, I can’t help but ask myself how we can do better.

More than half of the patients seen at Texas Children’s Hospital are covered by Medicaid, a program that celebrates its 50th anniversary this month. It was July 30, 1965, when President Lyndon B. Johnson signed the Social Security Amendments of 1965 and established the Medicare and Medicaid programs. From that moment, health care became more accessible to the most vulnerable of our U.S. population.

In the 50 years since then, Medicaid has benefitted millions of children and pregnant women – including hundreds of thousands of Texas Children’s patients. Medicaid-designated funds for research have helped us advance pediatric medicine for the benefit of all of our patients, not just those covered by Medicaid. In fact, it’s core to our mission here at Texas Children’s and the principles on which we were founded.

And while Medicaid remains a major part of health care in the U.S., our world today is quite different than the one in which it was created. Medicaid needs to be adapted to the practices of 21st century medicine, and the discourse surrounding it should address the long-term viability and reforms necessary to preserve a program that serves the most vulnerable of our community: impoverished pregnant women and children.

The simple truth is our federal and state governments save money by investing in health care for our children. When kids grow up with regular health exams, immunizations and care for childhood illnesses, they are more likely to become adults who are healthy and productive taxpayers.

Reform is slow but on the horizon, in the form of policies at the state and national levels, as well as homegrown efforts like many Texas Children’s has already implemented, to make health care more accessible for our own underserved population here in Houston and the surrounding areas.

Here, we are constantly working to advance health care access for our Medicaid patients. Through the creation of community resources such as The Center for Children and Women in Greenspoint and Southwest Houston, we are ensuring care is readily accessible in the community where our patients need it most.

This year, we added our sixth Texas Children’s Pediatrics Community Cares practice to provide access to pediatric primary care in some of Houston’s most underserved communities. When we have these families in our care, we connect them to vital health and social services and help them enroll in Medicaid through our health plan if they are uninsured. Without this program, many of these families would seek care from emergency rooms or possibly go without treatment due to low family incomes and/or lack of health insurance.

We advocate for Medicaid support and continued reform because we know it’s the right thing to do for our patients. This is because we know who our patients are. They are hardworking, and they want the best for their children and their families. And they are like many people who rely on Medicaid at some point. Almost 80 percent of children who were enrolled in Medicaid in 2013 lived with at least one parent who worked. That same year, 65 percent of adults on Medicaid were also part of a working family.

Many of these families don’t earn enough to afford private coverage and are desperate for a way to provide the right health care for their children. For many of our patient families, Medicaid covers those who would otherwise face financial ruin due to a catastrophic medical diagnosis or unexpected event. Medicaid is a safety net for everyone because we are all one medical crisis or catastrophic event away from financial ruin. It is a stepping stone for people when the unexpected occurs.

You and I know these families, and we know their stories. It’s our duty to remind others how essential Medicaid is for our community and for those families who truly need it.


Get involved

This session, lawmakers failed to invest in Medicaid, a program that promotes economic stability for our state. Leaders need to have a longer-term vision than just two years. I am hopeful that during the interim, lawmakers will engage with various stakeholders – those providing care and those who consider its policies – to craft a 21st century Medicaid program that aligns Texas values with the actual needs of Texans.

Our government relations team acts as the advocate for children and women in Austin and Washington D.C. They work to educate legislators about why Medicaid matters and why it’s so essential to patients like ours. You can join their efforts by contacting your representatives and encouraging your friends and family to do the same.

As we acknowledge the 50th anniversary for this crucial program, I encourage you to advocate for health care that is available to all who need it, not just those who can afford it.

20 Responses to “Medicaid: Safety net and stepping stone”

  1. Rosie Valadez McStay

    Mark, thank you for this wonderful post! As the director of Government Relations and Community Benefits, I have the privilege of speaking on behalf of Texas Children’s with local, state and federal elected officials about Medicaid. Fortunately, I can point to so many examples of how we have lead the way in reforming this 50 year old program — Medicaid managed care, Delivery System Reform access and quality initiatives made possible through the Medicaid waiver, and strong hospital advocacy by our clinical and hospital community to increase reimbursement to providers, expand coverage and access options, and train the next generation of health care professionals. Medicaid MUST matter to every employee and supporter of Texas Children’s Hospital. As you said so beautifully in your blog post, “You and I know these families, and we know their stories. It’s our duty to remind others how essential Medicaid is for our community and for those families who truly need it.”

  2. Hasti Taghi

    I am so proud to work at an organization that provides the best care for all those who need it, not just those who can afford it. Health care at Texas Children’s is a right, not a privilege. Thank you for writing so honestly about this topic on the 50th birthday of Medicaid.

  3. Christy Brunton

    The work we are doing to care for these children is amazing and inspiring. Without Texas Children’s Hospital and the Medicaid program, these kids would have no place to go to receive the healthcare they need. Thank you for being the kind of leader that reminds the community and our own employees that we will never turn a child away regardless of their ability to pay. It’s what we do and what we will keep doing…it’s doing the RIGHT thing all the time!

  4. Krisanne Graves

    Mr. Wallace, just the first sentence of this post contains some very powerful information! These 50 years of Medicaid have seen significant changes in the country, its population and health systems. Your numbers help highlight the importance of the work done here at Texas Children’s on a daily basis, reminding us all that one patient at a time we can help to improve their lives. Thank you.

  5. Ann McClarney

    To know I work for an organization that will not turn away children, will help the ones most in need, regardless of their ability to pay is a privilage. We have such stong leadership, therefore we have a very strong organization. Thank you Mr. Wallace for setting the bar high, we all win!

  6. Susan Feigin Harris

    Wonderful message for everyone to hear and I encourage all to answer your call to voice their cry for a better Medicaid for Texas children. Kudos to Texas Children’s Hospital and system and you, Mark, for advocating for this and for leading the effort.

  7. Patrick Imarah

    The need for the sustenance of Medicaid cannot be overemphasized. More importantly, the need for reform to align with present day situations and best serve these children that need it, should be looked into with greater concern and empathy. I believe if we can empathize with these families, the approach to the much needed reform would be different. Afterall, these children of today could be the law makers of tomorrow.

  8. Cecilia Cece Mejorado

    Medicaid Matters. Yes it does, I have had the honor to work for Texas Children’s Health Plan 12 years and counting. I am not only an employee but a participant of Medicaid as well. Thank you to all who speak up for the children in need. Thank You Mr. Wallace

  9. Kathy Eckstein, Children's Hospital Association of Texas

    About three-fourths of Medicaid clients in Texas are children, and this health coverage can have long-term benefits that last into adulthood. Longitudinal studies of Medicaid expansions in the 1980s and 1990S have shown that children with access to Medicaid showed a 26 percentage point decline in the incidence of high blood pressure in adulthood, as well as lower rates of hospitalization and emergency room use. Children who gained access to Medicaid were less likely to drop out of high school and more likely to graduate from college. The investment also led to greater economic success as adults, with less reliance on safety net programs and increased overall earnings. Medicaid provides children an opportunity to improve long-term life outcomes. (

  10. Katherine Barillas, Ph.D.

    Cutting physical and behavioral health services provided by Medicaid jeopardizes the stability of families and the safety of children. For the past two sessions, the legislature has worked diligently to ensure children aren’t relinquished to the state’s custody because of untreated mental health needs. In addition, Child Protective Services has highlighted the significant number of children with primary medical needs who end up in foster care because their parent’s cannot obtain or are overwhelmed by their child’s complex needs. When children enter foster care they are the state’s legal responsibility and their care costs millions more than it would treating them in the community. Regardless of the political arguments that surround Medicaid, cutting reimbursement rates will have disastrous effects both financially and on the lives for which the state is responsible.

  11. Mary Jo Andre

    Mark, thanks so much for all you do to advocate for those children and families who need our help. Your passion helps drive our passion, and as a nurse, this vision is what attracted me to Texas Children’s. I hope that all nurses will follow your lead and help advocate for this program that allows us to deliver care to those who are in need our services. Thanks again for your leadership in these efforts.

  12. Angela Hudson

    As a Texas Children’s employee, it is so reassuring to me to see our leadership so firmly planted on the subject of Medicaid. It is clear that we are focused on health care access for ALL children, and that makes me really proud. Mr. Wallace, I appreciate your advocacy – that is leadership. And because of that leadership, we as an organzation are leading the way to ensure the community’s children receive the care they deserve. Thank you!

  13. Jamil Joyner

    I am a primary care pediatrician, and I care deeply about the fate of our next generation. Children with access to health care have better educational and economic futures in front of them. I am grateful Texas Children’s Hospital has been a supporter of the Medicaid program. The Medicaid program makes sense for all Texans. Our economy relies on healthy, working adults. Children who are healthy have more of a chance to be productive citizens in the future. Adults who are able to provide adequate health care to their children are able to focus on their jobs.
    The Medicaid program makes sense for the entire Texas economy. Researchers at Rice University’s Baker institute estimate that accepting the Medicaid expansion in Texas would add $90 billion to the state economy. Please see their article from the Houston Chronicle (
    I see a large population of Medicaid patients. They are all of our children. They grow, laugh, develop, and struggle as all children do. I do not need to share specific stories of my patients because their story is universal. I am glad Texas Children’s Hospital has committed to making all children’s stories a little brighter.

  14. John Clark, Jr., MD

    As a TCP provider caring for east Houston’s children, 50% of whom are covered by Medicaid, I applaud your recognition of this momentous occasion. As you know, parents, pediatricians, nurses, and all others who love and care for children have battled insurance companies and government to ensure adquate financial coverage for pediatric medical care. Often times, the struggle has been uphill. With increased resistance by Medicaid servicers to pay doctors and therapists for their care and fewer providers willing to see children covered by Medicaid, the smallest and least represented amongst us suffer the most. I am glad to work for a company that is willing to serve the underserved children of Houston. Thanks TCH!

  15. Kristen Cover

    Thank you so much Mr. Wallace! I’ve had the honor of working with Medicaid families for 10 years and it is essential for people to understand that our families are doing what is right for their children’s health. It essential that we offer healthcare access to the next generation, regardless of income. Medicaid Matters!

  16. Kelli Santana, Practice Leader, The Center for Children and Women

    Mark, thank you for being such a strong advocate and inspiring us to lead with such passion and dedication. As a Practice Leader at The Center for Children and Women, nothing makes me prouder than to see what a difference our team is making in the lives of those in need here in the Southwest community. Without people like you and organizations like TCH, operations like The Centers would not be possible, and a multitude of opportunities to “do good” would be lost. Thank you!

  17. Janta Rainey

    I am new as an employee to the TCHP family where we have the opportunity to assist families served by Medicaid programs everyday but I have worked in community outreach in Houston area for the last 25 years. The Medicaid program is so valuable to so many. Any one of us could have our name added to the list of recipients on any given day due to unforeseen circumstances in our lives. To see the smiles on the faces of parents or hear the reassurance in their voices as they are reassured that their child will be able to access the care that they are needing is priceless. Thank you Mr. Wallace for advocating for change and continued development of this much needed program!

  18. Adrian McKinney

    Thank you for your recent blog on the importance and the need for Medicaid reform, health coverage and healthcare funding for some of our most vulnerable patients. I am so fortunate to celebrate 25 years as a nurse with Texas Children’s this month and have seen the increase in Medicaid funded care over the years. Since 2008 I have had the privelege of working first hand with low-income (Medicaid eligible), first-time mothers and families in our community through the Nurse Family Partnership Program under Texas Children’s Health Plan. This proactive public health program was legislated into existance and funded mostly through Texas Government funds via Senate Bill 156. It was a real eye-opener as a nurse to transition from the Hospital setting to the Community setting and work hand in hand with low-income families in their home, week after week for over 2 years with each family helping them to navigate health services, provide education, goal setting and support with the ultimate goal of health and economic sufficiency. This “population” in society can be misunderstood, mis-judged, and looked down upon. For these families, having Medicaid and health coverage levels the playing field a tiny bit and makes a huge difference in the lives of these children and their family in their ability to follow through with preventative care as well as providing a means to treat serious health conditions that require ongoing care. In a climate where Medicaid funding is tight I have good news! I am happy to report that the Nurse Family Partnership program received additional funds this legislative session to expand the reach and service to this vulnerable population in Houston. I am proud to represent and be a part of the Texas Children’s family where the culture is to provide “Service with a Heart” always and to everyone we touch.

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