Skip to Content

Filter by:

Washington Highlights

MACPAC Meets to Discuss Children’s Health Insurance Coverage

January 29, 2016—The Medicaid and CHIP Payment and Access Commission (MACPAC) met Jan. 28 to review its previous work on children’s health insurance coverage and begin initial discussions on potential future recommendations.

The commission reviewed a draft chapter for its March 2016 Report to Congress on the affordability of separate Children’s Health Insurance Program (CHIP) compared to exchange coverage for children. The chapter finds that out-of-pocket spending (premiums and cost sharing) in exchange coverage is higher than CHIP in 36 states with separate CHIP programs. It also concludes that out-of-pocket spending in exchange plans increases substantially as income rises.

Commission staff also presented a new analysis comparing low and moderate income families’ out-of-pocket spending for employer-sponsored insurance with their out-of-pocket costs for separate CHIP programs. They found that children face higher average spending in employer-sponsored insurance plans than in separate CHIP plans. Additionally, they found that children between 133-150 percent of the federal poverty level (FPL) are more likely to exceed various spending thresholds in employer-sponsored insurance than exchange coverage, while children at 200 percent FPL or above are less likely to exceed those thresholds.

Earlier this month, MACPAC and the Medicare Payment Advisory Commission (MedPAC) jointly released a data book on beneficiaries dually eligible for both Medicare and Medicaid to create a common understanding of the characteristics of these beneficiaries and their use of services, including data on expenditures, health care utilization, demographics, and personal characteristics. The purpose of this report is to inform Congress, as well as each commission’s discussions of the policy issues associated with this population.

Additional information on the MACPAC individual sessions, transcripts, draft reports, and data books can be found on the website. The commission’s next meeting will be March 31.


Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806

Scott Wetzel, M.P.P.
Lead, Quality Reporting
Telephone: 202-828-0495


envelope on a green background

Subscribe to Washington Highlights

RSS icon

Subscribe to RSS

Washington Highlights, a weekly electronic newsletter, features brief updates on the latest legislative and regulatory activities affecting medical schools and teaching hospitals.

Past Issues

For More Information

Jason Kleinman
Sr. Legislative Analyst, Govt. Relations
Telephone: 202-903-0806