HB 6937, An Act Concerning Medicaid Coverage For Medically Necessary Children’s Diapers

TESTIMONY OF THE CONNECTICUT HOSPITAL ASSOCIATION
SUBMITTED TO THE HUMAN SERVICES COMMITTEE

Thursday, February 27, 2025

The Connecticut Hospital Association (CHA) appreciates this opportunity to submit testimony concerning HB 6937, An Act Concerning Medicaid Coverage For Medically Necessary Children’s Diapers. CHA supports this bill.

Connecticut hospitals and health systems care for patients, strengthen the state’s economy, and support vulnerable communities across the state. Every day, they work to improve healthcare access, affordability, and health equity. Even as they face ongoing challenges, hospitals provide world-class care to everyone who walks through their doors, regardless of their ability to pay. Hospitals also support an exemplary workforce as the largest collective employer in the state, contribute significantly to the state’s economy, and invest in their communities addressing social drivers of health.

HB 6937 calls for Medicaid coverage for children’s diapers when medically necessary to prevent or ameliorate (1) severe and persistent diaper dermatitis, urinary tract infection, or other disease of the skin related to inadequate diaper hygiene, or (2) another health condition including, but not limited to, a developmental, psychiatric, or neurological condition that results in an unusual need to void or delay developmentally appropriate toileting behavior.

CHA supports this bill because it extends current coverage for children ages 3+ to children under age 3 using a targeted preventive and treatment approach based on individual determinations of medical necessity.

Health and Economic Challenges Related to Diaper Need

Diaper insecurity, the experience of cutting back on or forgoing other basic needs to afford diapers, is increasingly recognized as a social driver of health. One in two families in the U.S. have diaper insecurity, which can increase the frequency of common skin conditions like diaper dermatitis (“diaper rash”) and fungal infections like candidiasis that are the underlying causes of urinary tract infections (UTIs), the most common bacterial infection related to inadequate diaper hygiene. In several studies, diaper insecurity was found to be the number one risk factor for postpartum depression in new mothers. These effects on maternal and infant health contribute to an increase in healthcare utilization and associated costs.

Maintaining proper diaper hygiene, including frequent diaper changes and proper cleaning, can help prevent the diaper related skin conditions such as those noted above. The proposed diaper coverage in HB 6937 is targeted to those for whom coverage is medically necessary and will reduce unnecessary healthcare utilization.

Diaper insecurity can impact the amount of funds within a household budget available to pay for other necessities, such as the rent, mortgage, or utility bills, and can also impact a family’s income due to requirements that caregivers provide diapers when placing a child with a childcare provider. Childcare providers typically require families to provide a diaper supply for the time their child is in care, even if childcare costs are subsidized. If parents cannot furnish the requisite diapers, they may need to stay home and care for their child instead, losing wages until they can provide diapers for the return to childcare and work. In fact, a study by the National Diaper Bank Network noted that families missed a week of work a month on average because they did not have a sufficient supply of diapers. For families without paid time off who are living close to the federal poverty line, this could result in up to $8,000 of income lost a year.¹

Better Health Outcomes and Economic Opportunity

In addition to the promotion of maternal, infant, and child health, the provision of diapers to children under age 3 when medically necessary supports economic opportunity for families. For example, the same National Diaper Bank Network study referenced above found that for every $1 spent on the provision of diapers through diaper banks, $2 were saved in healthcare and economic costs.1 A 2018 economic modeling study of diaper provision by The Diaper Bank of Connecticut (DBCT) and the University of Connecticut found that the incidence of diaper rash declined by 33% and infants experienced 77% fewer days of diaper rash when families received supplies of clean diapers. The study also predicted that every dollar spent relieving diaper need resulted in an elevenfold increase in personal income for families who can’t afford diapers.²

Research from the University of North Carolina and the Diaper Bank of North Carolina demonstrates that providing diapers to families increases family engagement with additional wraparound services which can lead to increased attendance at pediatric well-child visits and adherence to immunization schedules.³ This increases the chance of early detection by providers of symptoms of childhood disease, risk factors for UTIs and avoidable emergency department visits and hospitalizations. Given this, in order to achieve the full benefit of this bill’s implementation, the Department of Social Services (DSS) should consider leveraging the infrastructure that exists with the Diaper Bank of Connecticut’s extensive diaper distribution network which includes hospitals and their community partners to help connect families to wraparound services to improve the overall wellbeing of families.

HB 6937 proposes to address diaper insecurity with a strategic, targeted policy intervention that prevents the sequelae of medical conditions that result in frequent avoidable hospital or professional visits or more serious events, such as hospitalization for acute kidney injury due to frequent urinary tract infections. Providing coverage for diapers when medically necessary is essential and appropriate care. It is also an effective preventive health and early intervention strategy that benefits both children and their caregivers.

Thank you for your consideration of our position. For additional information, contact CHA Government Relations at (203) 294-7301.

¹ Massengale, KE; Comer LH; et al. “The Impact of diaper distribution by diaper banks on child health and economic impacts study” 2025 Am J Preventive Medicine, Under Review.
² https://ccea.uconn.edu/2018/05/05/better-health-of-children-the-social-and-economic-impacts-of-the-connecticut-diaper-bank/
³ Massengale, KEC; Toller Erausquin, J; Old, M.. “Organizational and health promotion benefits of diaper bank and community-based organization partnerships” 2017 Children and Youth Services Review