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  • Washington Highlights

    MACPAC Discusses March Report, Future of CHIP

    Jason Kleinman, Senior Legislative Analyst, Govt. Relations

    The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) Jan. 22-23 met to review draft chapters for its March Report to Congress and discuss policy issues related to the future of CHIP.

    The commission discussed several policy goals regarding the future of children’s healthcare, including the need for affordable coverage, necessary adequacy of coverage, reduction in gaps in coverage, fair treatment of states, and appropriate use of public dollars.

    Several draft chapters in the March report will focus on the future of CHIP. Under current law, federal funding for the program will expire at the end of fiscal year (FY) 2015. Based on projections for MACPAC by the Urban Institute that will be included in the report, 1.1 million children would become uninsured in 2016 if CHIP is not reauthorized.

    A draft chapter that examines the affordability of exchange coverage for children now covered by CHIP concludes that the total average costs for children’s exchange coverage are more than twice that of CHIP if parents are enrolled in an exchange and more than seven times that of CHIP if parents are not enrolled in an exchange. The authors provide several possible policy approaches to address affordability, including: augmenting existing exchange subsidies, providing wrap-around coverage, and expanding Medicaid.

    Another draft chapter compares CHIP benefits to Medicaid, exchange plans, and employer-sponsored insurance. The chapter finds that most major medical services are covered by all sources of coverage. The authors provide several possible approaches for addressing the comparability of benefits, including: changing the essential health benefits (EHB) definition of pediatric services, providing states the option of establishing a pediatric-specific EHB benchmark, and requiring all exchange plans to embed pediatric dental coverage.

    The final draft chapter on CHIP focuses on network adequacy and the future of CHIP. The chapter concludes that network adequacy regulations are largely similar between Medicaid, CHIP, and exchange plans.

    Other draft chapters in the March report focus on Medicaid’s role in behavioral health, the effect of Medicaid coverage of Medicare cost sharing on access to care, and an update on the Medicaid primary care payment increase.