THE FUTURE OF CHILDREN’S COVERAGE CARRIE FITZGERALD, VICE PRESIDENT, CHILDREN’S HEALTH PROGRAMS

A look back at 2018 and what we got for CHIP:

CHIP funding expired on September 30th, 2017 CHIP funding expired on September 30th, 2017. Until January 23, 2018, states relied on carryover funds, redistribution funds, and partial fiscal 2018 allotment.

MUCH TURMOIL During those months states reviewed their CHIP programs and enrollment very closely. Several states, Alabama, Colorado, Connecticut, Oklahoma, Utah, Virginia, Washington, and West Virginia determined they had to wind down their programs completely. Some states sent letters to families and some states prepared to freeze enrollment.

Between the HEALTHY KIDS Act and the ACCESS Act, CHIP was extended for ten years, through September 30, 2027. The HEALTHY KIDS Act extended CHIP for six years, and two weeks later, the ACCESS bill extended CHIP for four more years.

The CHIP matching rate, which had been increased in the ACA by 23% and then extended in MACRA , remains through FFY 2019. In FY2020, the rate drops by 11.5% and in FY2021, the rate will drop to the state’s regular e-FMAP rate –reducing it by about 23%.

Maintenance of Effort – MOE – The MOE from the Affordable Care Act (ACA) is extended through FY2027 but will be modified in certain states in FY2020. That change will allow states that cover children over 300% FPL to scale back on that eligibility or make it harder to enroll in coverage.

Other CHIP-related extensions: Pediatric Quality Measures are extended though FY2027with an additional $150 million in funding over those years. Mandatory Quality Reporting – Starting in FY2024 -All states will be required to report the Child Core Set quality measures in Medicaid and CHIP (it is currently voluntary).

CHIP look-alike plans Express Lane Eligibility – (ELE) is authorized through FY 2027 and allows states to use findings from other means-tested programs to determine eligibility and enroll kids in Medicaid and CHIP. Childhood Obesity Programs – Extends the CDC demo project through FY2023 with a $30 million appropriation Outreach and Enrollment: Program funded through FY2027 included $168 million in funding over those years, Included parent mentors as eligible means to do outreach.

The funding in the last year is tricky and could make CHIP harder to renew. Making CHIP permanent is a goal for us.

Children’s coverage went down in 2017 for the first time in a decade Children’s coverage went down in 2017 for the first time in a decade. What can we do to prevent that from happening again? No cuts, block grants, or per capita caps to Medicaid Keep CHIP strong and stable (no rescission) Ensure robust and active outreach and enrollment

THREATS/OPPORTUNITIES FOR KIDS COVERAGE Proposed Public Charge Rule State options: ICHIA (Immigrant Children’s Health Care Improvement Act) Expand CHIP eligibility level Medicaid Expansion Medicaid for All bills – health care expansion bills

CARRIE FITZGERALD CARRIEF@FIRSTFOCUS.ORG Thank you! CARRIE FITZGERALD CARRIEF@FIRSTFOCUS.ORG