MACPAC Releases March Report to Congress

The first half of the report focuses on CHIP, which without congressional action will exhaust its federal funding at the end of fiscal year (FY) 2015. The commission reinforced its June 2014 recommendation to extend federal funding for CHIP for two years while options are developed to address concerns about affordability and adequacy [see Washington Highlights, June 20, 2014].

The March Report contains new analysis conducted by the Urban Institute that finds that if CHIP funding is not renewed and states exhaust their federal balances, one-third of the children, or approximately 1.1 million, currently enrolled in separate CHIPs would become uninsured.

The report also examines the affordability of exchange coverage for children currently covered by CHIP. The average additional costs for exchange coverage are estimated to be more than twice that of CHIP if the children’s parents are already enrolled in exchange and more than six times higher than CHIP if the children’s parents are not enrolled, depending on income.

Additional chapters on CHIP focus on provider networks and comparing CHIP benefits to Medicaid, exchange plans, and employer-sponsored insurance. While the commission has heard concerns about the adequacy of the exchange networks, they felt that it was premature to draw conclusions or make recommendations regarding how the interaction between Medicaid, CHIP, and exchange plan networks would affect access to care for children. The commission will continue to monitor these issues.

The final chapter of the report is dedicated to the Medicaid primary care payment update. The commission highlighted the complications with the rate increase implementation, and ultimately concluded that there was not sufficient evidence to say whether the payment increase had an effect on beneficiary access or provider participation.