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  • Washington Highlights

    MACPAC Releases March 2017 Report to Congress, Recommends CHIP Extension to 2022

    Len Marquez, Senior Director, Government Relations

    The Medicaid and CHIP Payment and Access Commission (MACPAC) March 15 released its March 2017 Report to Congress on Medicaid and CHIP, which focuses on providing health insurance to children, making payments to safety-net hospitals, and monitoring access to care under managed care and fee for service. The commission makes nine recommendations in its March report.

    The first chapter reprises the commission’s January recommendations regarding the future of the Children’s Health Insurance Program (CHIP). In general, the nine recommendations include an extension of federal CHIP funding through fiscal year (FY) 2022 to ensure continuity of coverage for low to mid-income children and to mitigate states’ budget uncertainties. The commission also recommends support for states to test innovations that will streamline the program.

    The second and third chapters discuss the analysis of Medicaid disproportionate share hospital (DSH) payments and various approaches to increasing the federal eligibility criteria in an effort to better target DSH payments. The commission’s analysis shows that uncompensated care is falling nationally, decreasing more in states that expanded Medicaid under the Affordable Care Act (ACA, P.L. 111-148 and P.L. 111-152). However, despite the decline in uncompensated care, deemed DSH hospitals continued to report negative operating margins.

    The final chapter of the report discusses how states monitor Medicaid beneficiaries’ access to health care. The commission finds that even when controlling for socioeconomic characteristics and health status, Medicaid beneficiaries have higher utilization and better access to care than individuals without insurance have.