Data Report Shows Vulnerable Children and Teens Forgoing Mental Health Care During COVID-19 Public Health Emergency

Data recently released by The Centers for Medicare & Medicaid Services (CMS) highlights the continued impact the COVID-19 Public Health Emergency (PHE) is having on Medicaid and Children’s Health Insurance Program (CHIP) beneficiaries and utilization of health services. The data show that, from March through October 2020, beneficiaries have foregone millions of primary, preventive, and mental health care visits due to the COVID-19 PHE, compared to the same time period in 2019. Although utilization rates for some treatments have rebounded to pre-pandemic levels, mental health services show the slowest rebound. This decline in utilization is occurring at a time when preliminary evidence shows mental health conditions have worsened nationwide. The gap in service utilization due to the PHE, particularly for mental health services, may have a substantial impact on long-term health outcomes. Medicaid and CHIP-funded mental health services, in addition to primary and preventative services, cover the majority of children, people living in poverty, and those with special health care needs. Medicaid and CHIP also cover millions of racial and ethnic minorities.

The Connecting Kids to Coverage National Campaign, a national outreach and enrollment initiative funded under the Children's Health Insurance Program Reauthorization Act (CHIPRA) and the Affordable Care Act, has recently launched a Mental Health Initiative, which includes a digital video, print materials and social media graphics that promote mental health services, which are covered under Medicaid and CHIP.

Additional Data Highlights
Specifically, the data demonstrate a 34% decline in the number of mental health services utilized by children under age 19, compared to the same time period in 2019, and 22% decline in the number of mental health services utilized by adults aged 19 to 64, compared to the same time period in 2019. This translates to approximately 14 million fewer mental health services for children and approximately 12 million fewer mental health services for adults, for a total of nearly 26 million fewer mental health services utilized across both groups. Similarly, although there are preliminary reports of increased drug-related mortality due to the COVID-19 PHE, substance use disorder service utilization fell by 3.6 million services (13% decline) when compared to the same time period in 2019. 

It is important to note that the data show that utilization rates for certain primary and preventive services for children under age 19 have recovered to pre-pandemic levels, or have started to rebound across many areas of the country. While this recovery is encouraging, millions of services still need to be delivered to make up for those missed between March and October 2020. Preliminary 2020 data shows 9% fewer childhood vaccinations for beneficiaries under age two (1.8 million services), 21% fewer child screening services (4.6 million services) among children under age 19, and 39% fewer dental services (11.4 million services) among children under age 19 when compared to pre-pandemic levels. This data takes into account increases in services delivered through telehealth.

Throughout the pandemic, CMS has encouraged states to consider telehealth options to combat COVID-19 and increase access to care. This updated data snapshot demonstrates a marked increase in the number of services delivered via telehealth compared to prior years. The number of services delivered via telehealth surged 2,700% during the PHE to nearly 68 million between March and October 2020. However, this increase has not been enough to offset the overall decline in service utilization.

For COVID-19 treatment and acute care use, the preliminary findings show more than 1.2 million Medicaid and CHIP beneficiaries received COVID-19 treatment, and nearly 124,000 were hospitalized through October 2020. Despite significant variance across states regarding this data, preliminary results suggest that the COVID-19 treatment rate increases with age. In addition, Medicaid and CHIP paid for nearly 10 million COVID-19 tests or testing related services, although this data does not include tests provided free of charge or covered by other insurance programs, including Medicare.

View the press release, fact sheet and data report for additional information.

Stay Connected with the Campaign 

• Share our Campaign materials. Our ever-growing, multi-lingual Outreach Tool Library features a variety of targeted resources to use in your outreach and enrollment efforts, available in multiple formats.
• Contact us. To get more involved with the Campaign, contact us via email at ConnectingKids@cms.hhs.gov.
• Follow the Campaign on Twitter. Remember to re-tweet or share our messages from @IKNGov with your social network and be sure to use our #Enroll365 and #KidsEnroll hashtags in your posts.

Subscribe to the “Campaign Notes” eNewsletter
The Connecting Kids to Coverage National Campaign eNewsletter “Campaign Notes” is distributed throughout the year and provides updates on Campaign activities. If a friend or colleague forwarded this email to you, we invite you to sign up to receive this eNewsletter directly to your inbox.

The Centers for Medicare & Medicaid Services (CMS)

To contact CMS, please visit our contact us page. 

  A Note About the Significance of CMS’s
“Connecting Kids to Coverage” National Campaign 

A Message from Health & Human Services Secretary Xavier Becerra

Today our nation’s children are living through challenging times: social isolation due to the COVID-19 pandemic, the seemingly endless epidemic of mass shootings, and the economic toll that this pandemic has taken on families. And all of this is taking a toll on impacting our children’s mental health.

Our children deserve to be children, but when the conflicts of the world force themselves into their lives, that’s when we need to step in and make sure that they are protected. Fortunately, most children have access to health coverage; unfortunately, millions of children remain uninsured. What’s more, kids in minority communities have disproportionately high rates of uninsurance. These facts make CMS’ Connecting Kids to Coverage National Campaign all the more important.

The Connecting Kids to Coverage National Campaign’s mission is to promote the enrollment of eligible children in Medicaid and the Children’s Health Insurance Program (CHIP), thereby affording their families the peace of mind of knowing they have health coverage. Not only do these programs cover preventive care, but they cover much needed mental health services.

On this Mental Health Awareness Month, I want to reiterate HHS’s commitment to extending health insurance to all our nation’s children and to giving parents the tools they need to help ensure their children develop into healthy adults. As Frederick Douglass said more than one hundred years ago, “It is easier to build strong children than to repair broken men.” That remains as true today as it did back then.

I want to thank CMS and all the Campaign’s partner organizations for working to amplify the message of this campaign, and I want to encourage parents whose kids are uninsured to enroll in Medicaid and CHIP. Together, we can help this nation’s children grow into healthy adults.

Connecting Kids to Health Coverage
Across the U.S., more than 94% of children have health insurance, however, millions remain uninsured. Among those uninsured, those in minority communities face high rates of uninsurance. In fact, American Indian and Alaska Native (AI/AN) children continue to have the highest uninsured rates by race and ethnicity; followed by Hispanic children. African Americans have the lowest rate of uninsured children apart from Asian, Native Hawaiian, and Pacific Islander children.

There are a variety of reasons that minority populations face barriers to enrolling in health insurance, a few of which include language, lower literacy rates, and limited access to enrollment assistance. It is crucial that children are covered by health insurance to stay up to date on preventive care, promote physical and social development, and succeed academically. Data show that children with health insurance are less likely to miss class and more likely to perform better in school compared to those who do not have health insurance.

Particularly in households that are low-to-mid-income, Medicaid and CHIP are a great option for kids’ health insurance. Not only does Medicaid and CHIP cover preventive care, it also covers routine check-ups, vaccinations, prescriptions, dental care, vision care, and mental health services.

Coverage of mental health services is particularly important right now with the ongoing COVID-19 public health emergency. Prior to COVID-19, as many as one in six U.S. children between the ages of 6 and 17 had a treatable mental health disorder. Since the start of the pandemic, children across the country have been facing additional stressors such as a disruption of familiar routines, schooling and socialization, as well as economic and other impacts on families, leading to a surge of anxiety and depression in young people. In addition, mental health disparities exist across race, gender, and geographic location. Due to COVID-19, many routine well-child visits may have been postponed, keeping children from getting important preventive services. Between March through July 2020, compared to data from the same period in 2019, CMS found in a data snapshot that children insured by Medicaid and CHIP participated in fewer routine care visits, which includes  8.4 million (35%) fewer outpatient mental health services, even after accounting for the increased use of telehealth. 

Coverage with Medicaid and CHIP includes developmental and behavioral health screenings and services delivered via telehealth. Early intervention and access to essential mental health services can help children get the support they need to meet important developmental milestones. While promoting access to mental and behavioral services is a year-round mission for us (and many of you)—May is Mental Health Awareness Month, which is an opportune moment for organizations to focus on this critical benefit in our efforts to enroll eligible children in Medicaid and CHIP, and encourage our current beneficiaries to access these services.

Medicaid and CHIP offer free or low-cost health insurance for kids and teens up to age 19. The Connecting Kids to Coverage National Campaign resources below can help organizations promote health insurance coverage through Medicaid and CHIP and connect children of all backgrounds to health care.

Campaign Resources

• Mental health resources

Visit the “Mental Health Initiatives” page to find all of the Campaign’s mental health resources in one place, including a :15 second digital video. These resources can be used to encourage parents and caregivers to enroll in Medicaid and CHIP to access important mental health benefits once their children and teens are covered.

• Print materials in multiple languages

Organizations can use these inclusive, multi-language print materials to assist in outreach. These materials can be placed throughout the community to increase awareness about Medicaid and CHIP. Available languages include French, Marshallese, Spanish, Arabic, Burmese, Chinese, Farsi, Haitian Creole, Hmong, Korean, Portuguese, Russian, Somali, Tagalog, and Vietnamese. These materials can also be customized to include your organization’s name, logo, and other state-specific information. See our customization guide on how to submit your request.

• Multicultural, AI/AN resources

There are many resources to help reach children and families, including multicultural outreach resources, the Outreach and Enrollment fundamentals guide for AI/AN children, and tips for conducting outreach in rural communities.

Upcoming Observances
There are national observance opportunities for partners to share Campaign materials to spread the word about the services and benefits of Medicaid and CHIP. Upcoming observances include:

• Mental Health Awareness Month (May)
• National Asthma and Allergy Awareness Month (May)
• Safety & Health Week (May 2 – 8)
• Children’s Mental Health Awareness Day (May 7)
• Mother’s Day (May 9)_­­

Stay Connected with the Campaign 

• Share our Campaign materials. Our ever-growing, multi-lingual Outreach Tool Library features a variety of targeted resources to use in your outreach and enrollment efforts, available in multiple formats.
• Contact us. To get more involved with the Campaign, contact us via email at ConnectingKids@cms.hhs.gov.
• Follow the Campaign on Twitter. Remember to re-tweet or share our messages from @IKNGov with your social network and be sure to use our #Enroll365 and #KidsEnroll hashtags in your posts.

Subscribe to the “Campaign Notes” eNewsletter
The Connecting Kids to Coverage National Campaign eNewsletter “Campaign Notes” is distributed throughout the year and provides updates on Campaign activities. If a friend or colleague forwarded this email to you, we invite you to sign up to receive this eNewsletter directly to your inbox.

The Centers for Medicare & Medicaid Services (CMS)

To contact CMS, please visit our contact us page. 

Webinar on 4/29 – Register Now!
Promoting Mental and Behavioral Health Resources to Help Children and Teens Enroll in Coverage and Access Care

The Connecting Kids to Coverage National Campaign Invites You to Attend a Webinar:

Promoting Mental and Behavioral Health Resources to Help Children and Teens Enroll in Coverage and Access Care

Thursday, April 29, 2021
2:00 p.m. – 3:30 p.m. ET

Medicaid and the Children’s Health Insurance Program (CHIP) cover essential mental and behavioral health services for kids and teens. For Mental Health Awareness Month, observed in May, the Connecting Kids to Coverage National Campaign (the Campaign) webinar will cover the current landscape of mental health service usage among children and teens, as well as offer ideas organizations can use to help children and teens in their communities access these important mental and behavioral health services.

Prior to the COVID-19 public health emergency, as many as 1 in 6 U.S. children between the ages of 6 and 17 had a treatable mental health disorder. With additional stressors, such as lack of routine and virtual learning, there has been a surge of anxiety and depression in young people since the start of the pandemic. Despite this surge, mental health services declined sharply among children age 18 and under. Although delivery of care via telehealth has helped connect children to important mental health services, data has shown that many children and teens are still not getting the care they need.

Join this webinar for the latest data on the use of mental health services, hear what partners are doing to help connect children to care, and learn about resources your organization can use in outreach and enrollment efforts. Learn about the Campaign’s many resources to promote mental and behavioral health on InsureKidsNow.gov, which include a digital video, social media, text messages, and newsletter articles.

Webinar speakers feature:

• Melinda Baldwin, Chief of the Center for Mental Health Services at the Substance Abuse and Mental Health Services Administration (SAMHSA)
• Kim Proctor, Technical Director, Data and Systems Group, Center for Medicaid & CHIP Services, Centers for Medicare & Medicaid Services (CMS)
• Jamie Poslosky, Senior Director, Advocacy Communications, American Academy of Pediatrics
• Gillian Ray, Vice President External Relations, Children’s Hospital Association
• Kelly English, PhD, LICSW, Director of the Children’s Behavioral Health Knowledge Center, Child, Youth, & Family Services Division, Massachusetts Department of Mental Health
• Darshana Panchal, MPH, Outreach Contractor, Connecting Kids to Coverage National Campaign, Porter Novelli Public Services

REGISTER HERE

We Want to Hear from You!
The Campaign wants to hear how organizations like yours are helping to connect children and teens to mental and behavioral health services. Send us an email at ConnectingKids@cms.hhs.gov. And visit our website to access slides and recordings from previous Campaign webinars._­­­­

Stay Connected with the Campaign 

• Share our Campaign materials. Our ever-growing, multi-lingual Outreach Tool Library features a variety of targeted resources to use in your outreach and enrollment efforts, available in multiple formats.
• Contact us. To get more involved with the Campaign, contact us via email at ConnectingKids@cms.hhs.gov.
• Follow the Campaign on Twitter. Remember to re-tweet or share our messages from @IKNGov with your social network and be sure to use our #Enroll365 and #KidsEnroll hashtags in your posts.

Subscribe to the “Campaign Notes” eNewsletter
The Connecting Kids to Coverage National Campaign eNewsletter “Campaign Notes” is distributed throughout the year and provides updates on Campaign activities. If a friend or colleague forwarded this email to you, we invite you to sign up to receive this eNewsletter directly to your inbox.

The Centers for Medicare & Medicaid Services (CMS)

To contact CMS, please visit our contact us page.