There is debate whether the program is still needed now that the Patient Protection and Affordable Care Act provides funding for states to expand Medicaid to families with incomes up to 138% of poverty. Some children's advocates, including the American Academy of Pediatrics' Committee on Child Health Financing, urge that the program be extended because of many uncertainties about children's coverage under the ACA. Advocates say shifting children from CHIP to other coverage could result in some losing insurance because of different state rules or parents being unwilling or unable to obtain family coverage.
The AAP's committee in January recommended that Congress fully fund CHIP through 2019.
If Congress does nothing, states next year would have to move children either to Medicaid or an exchange plan.
The AAP committee said near-poor children have gotten “enormous” benefit from CHIP since its inception 16 years ago: “With the passage of the ACA, the approach that the United States will adopt for this vulnerable segment of the population after 2015 is now subject to some uncertainty.”
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