The Medicaid and CHIP Payment and Access Commission recommends that the Children's Health Insurance Program should continue another five years. It is set to expire next year and the panel says something needs to be in place in case Republicans follow through with their plan to repeal the Affordable Care Act.
On Thursday, the panel voted 16-1 to suggest that Congress extend CHIP funding through Sept. 30, 2022. The suggestion will appear in the commission's March report to Congress.
The panel is also asking Congress to continue an enhanced match outlined by the ACA. The law gave states a 23% bump in federal matching rates, which was set to end Sept. 30, 2019. Through this bump, states received between 88% to 100% in federal matching rates, according to federal data.
Finally, MACPAC hopes Congress will extend an ACA provision that prevents states from reducing eligibility for enrollment below what was in place before the ACA. That policy was also set to end in September 2019 and the panel wants it to continue through the end of fiscal 2022.
The sum total of the recommendations will result in more than $13 billion in federal funding over five years, according to the Congressional Budget Office.
CHIP was established in 1997 with bipartisan congressional support. It serves about 8.4 million children in families earning up to 200% of the federal poverty level. If CHIP ends, MACPAC estimates that as many as 1.1 million children would become uninsured.
“I see us in a period of great uncertainty and I think providing stability for children, their families and the states administering the program provides a tremendous benefit,” said Alan Weil, a MACPAC commissioner and editor-in-chief of Health Affairs, a peer-reviewed health policy journal.
It's unlikely the next Congress, which will be controlled by the GOP, would heed all of MACPAC's recommendations. Republicans say the current makeup of MACPAC is too liberal.
However, congressional staffers say CHIP is considered important by members of both sides of the aisle.
The federal match or maintenance-of-effort provision will be hard sells, however. A discussion document released last year by House Energy and Commerce Health Subcommittee Chairman Joe Pitts (R-Pa.), full committee Chairman Fred Upton (R-Mich.), and Senate Finance Committee Chairman Orrin Hatch (R-Utah) proposed ending both provisions.
The Georgetown Center for Children and Families noted that ending the two provisions would restrict access to care .