Bipartisan House Bill is a Critical Step Forward for Children’s Health

UPDATE: On April 14, 2015, the U.S. Senate voted 92 to 8 to approve the Medicare Access and CHIP Reauthorization Act of 2015. The Senate considered but failed to pass an amendment to extend CHIP for four years rather than two. The legislation will now be sent to President Obama for signature.

On March 26, 2015, the U. S. House of Representatives overwhelmingly, and with bipartisan support, passed H.R. 2, the “Medicare Access and CHIP Reauthorization Act of 2015.”  If enacted, this bill would provide a long-term plan for Medicare payments, permanently repealing the cuts to physician payment levels that have been patched every year (the so-called “doc fix”).

The bill also includes a two-year extension of funding for the Children’s Health Insurance Program (CHIP), which provides affordable health insurance to 8 million low-income children. The passage of H.R. 2 is particularly important for children’s health because without additional funds the current funding will expire at the end of September, putting millions of children at risk of losing their health insurance.

In addition to the funding, the House bill maintains core policy components of CHIP that have made it such a successful program. These policy components include a requirement in the Affordable Care Act (ACA) that states maintain their CHIP eligibility and enrollment policies through 2019, a scheduled increase in the federal matching rate effective October 1, 2015, and $40 million dollars in grants for outreach and enrollment efforts. This blog from the Center for Children and Families at Georgetown University provides more details about the important policy aspects of the CHIP funding extension.

The bill also includes a two-year extension of Express Lane Eligibility (ELE), which allows states to use eligibility findings of other public assistance programs (e.g., Supplemental Nutrition Assistance Program or SNAP) to determine Medicaid and CHIP eligibility for children, simplifying the process for families who would otherwise have to provide the same information to multiple agencies. 

In addition, the bill permanently extends Transitional Medical Assistance (TMA), which provides temporary health care coverage to families who have lost Medicaid eligibility because a member of the household found a job or received a wage increase but cannot afford to purchase insurance in the private market. It also permanently extends the Qualified Individual program, which pays Medicare Part B premiums for over 400,000 beneficiaries with incomes between 120 and 135 percent of the federal poverty level who have limited assets.  It would provide two-year extensions of the Maternal Infant Early Childhood Home Visiting (MIECHV) program  and the Health Professions Opportunity Grants, which support career pathways for disadvantaged workers in the health sector.

The Senate is under pressure to pass this bill as soon as possible because the latest patch to the Medicare cuts expires on March 31. However, a vote in the Senate will not happen until at least mid-April, when Congress returns from recess. President Obama, along with advocates, supports this bill and wants the Senate to act quickly upon their return to send a bill to his desk. While CHIP funding does not expire until fall, this legislation is the best opportunity to extend it this year. Moreover, any further delays will make it hard for states to plan their budgets for next year.