Committee Members Likely To Support CHIP Extension Beyond 2015
During a meeting Thursday, members of the Medicaid and Children's Health Insurance Program Payment and Access Commission seemed to unanimously agree that Congress should continue funding CHIP beyond Oct. 1, 2015, when the program is scheduled to end, Modern Healthcare reports.
A MACPAC staff report circulated at the meeting noted that millions of children could lose their coverage if the program ends next year.
The program currently covers about eight million children in families with annual incomes up to 200% of the federal poverty level (Dickson, Modern Healthcare, 2/20).
According to MedPage Today's "The Gupta Guide," CHIP was reauthorized in 2009, but the Affordable Care Act left the program unchanged because Congress believed the law's expansion of Medicaid and subsidized coverage through its insurance exchanges would curb the need for a separate coverage program for children (Pittman, "The Gupta Guide," MedPage Today, 2/20).
Details of MACPAC Staff Report
However, the MACPAC staff report warned that as many five million CHIP beneficiaries could be at risk of losing coverage because they live in states that operate CHIP and Medicaid separately and they might not qualify for federal subsidies to offset the cost of private coverage through the exchanges. The report noted that CHIP beneficiaries in states with a combined Medicaid and CHIP program would eventually shift into Medicaid.
According to Modern Healthcare, MACPAC members during a discussion on the report offered comments indicating that they agreed with the report's conclusion, without any dissenting comments.
The report specified several demographic groups that potentially could lose coverage if congressional funding for CHIP stops and the program ends, including:
- Pregnant and undocumented immigrants, who currently are eligible for CHIP coverage until they deliver but who would lose coverage once the program ends;
- Children in lower-income families who might have to pay higher premiums or copayments under plans purchased through the ACA exchanges, which could discourage them from enrolling for coverage;
- Children in uninsured families who live in states that declined to expand Medicaid, because those families might be less likely to enroll their children in Medicaid; and
- Children of undocumented parents who are ineligible for either Medicaid or subsidized coverage through the exchanges and are unlikely to try and enroll their eligible children in coverage (Modern Healthcare, 2/20).
The report found that overall only about 44% of current CHIP enrollees would be eligible for subsidized exchange coverage, while the rest would be ineligible because their parents are covered through employer-sponsored plans ("The Gupta Guide," MedPage Today, 2/20).
In addition, the report listed some concerns about the differences in coverage between CHIP and exchange plans. For example, some of those plans, unlike CHIP, do not cover habilitative therapies. It also found that while CHIP plans permit out-of-network care in cases where in-network providers cannot treat a beneficiary's condition, some exchange plans do not.
Some MACPAC members acknowledged that CHIP cannot continue indefinitely, according to Modern Healthcare. Commissioner Donna Checkett -- vice president of business development for Aetna's Medicaid unit -- said, "We don't want to destroy anything, but it's not something that can continue in perpetuity either" (Modern Healthcare, 2/20).
Commissioner Judy Moore, a Maryland health consultant, urged the panel to develop recommendations for some type of a transition between CHIP and one that ensures its beneficiaries will remain fully protected and covered under the exchange plans ("The Gupta Guide," MedPage Today, 2/20).
MACPAC did not specify whether it would issue a formal recommendation to extend CHIP, but a spokesperson suggested the panel might address the issue it its June report to Congress. According to Modern Healthcare, the panel at a later meeting likely will discuss an extension timeline and how to transition children from CHIP to other coverage programs (Modern Healthcare, 2/20).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.