House Health Reform Bill Repeals Popular CHIP Program

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Monday, November 02, 2009 at 1:18 pm

Not even nine months after President Obama, with much fanfare, signed into law a five year, $33 billion reauthorization of the popular Children’s Health Insurance Program, House Democrats have proposed to dismantle it.

Under the $894 billion health reform legislation that House leaders unveiled last week, CHIP would cease to exist at the end of 2013, with kids enrolled in the program transitioning to plans on a proposed insurance exchange.

The move is raising concerns in the children’s advocacy realm, with some groups worried that higher costs on the exchange will prevent some kids from receiving health care.

In the Senate, Democratic leaders had also proposed to kill the CHIP program, but the program was salvaged by Sen. Jay Rockefeller (D-W.Va.), whose amendment preserving CHIP was passed by the Senate Finance Committee last month.

The House is expected to take up its health reform bill this week, with the Senate to follow later in the month. If those bills pass, the gaping disparity in approaches to the CHIP program will leave the fate of the program in the hands of the conference negotiators representing each chamber. Expect fireworks.

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bruce_webb
Comment posted November 6, 2009 @ 5:02 pm

This may be a tempest in a tea-pot considering the following language:
p. 1029 (4) CHIP TRANSITION REPORT.—Not later than December 31, 2011, the Secretary shall submit to Congress a report—
‘‘(A) that compares the benefits packages offered under an average State child health plan under title XXI in 2011 and to the benefit standards initially adopted under section 224(b) of the Affordable Health Care for America Act and for affordability credits under subtitle C of title II of division C of such Act; and ‘‘(B) that includes such recommendations
as may be necessary to ensure that—
‘‘(i) such coverage is at least comparable to the coverage provided to children under such an average State child health plan; and ‘‘(ii) there are procedures in effect for the enrollment of CHIP enrollees (including CHIP-eligible pregnant women) at the end of Y1 under this title, into a qualified health benefits plan offered through the Health Insurance Exchange, or into other acceptable coverage (as defined for purposes of such Act) without interruption of coverage or a written plan of treatment.’’.

In order to be a “qualified health benefits plan” it has to offer preventive services, well-baby care, and well-child care with no cost-sharing to the family and the “at least comparable” suggests that nothing covered now would in principal be lost. Those “higher costs in the Exchange” derive from the extension of coverage to the parents and not from any financial barriers to get coverage for the children. To the extent this is a problem it is not one of transitioning kids out of CHIP but instead one of affordability overall. If the services delivered end up the same or better I can't get too worked up by the labeling on the program.


bruce_webb
Comment posted November 6, 2009 @ 10:02 pm

This may be a tempest in a tea-pot considering the following language:
p. 1029 (4) CHIP TRANSITION REPORT.—Not later than December 31, 2011, the Secretary shall submit to Congress a report—
‘‘(A) that compares the benefits packages offered under an average State child health plan under title XXI in 2011 and to the benefit standards initially adopted under section 224(b) of the Affordable Health Care for America Act and for affordability credits under subtitle C of title II of division C of such Act; and ‘‘(B) that includes such recommendations
as may be necessary to ensure that—
‘‘(i) such coverage is at least comparable to the coverage provided to children under such an average State child health plan; and ‘‘(ii) there are procedures in effect for the enrollment of CHIP enrollees (including CHIP-eligible pregnant women) at the end of Y1 under this title, into a qualified health benefits plan offered through the Health Insurance Exchange, or into other acceptable coverage (as defined for purposes of such Act) without interruption of coverage or a written plan of treatment.’’.

In order to be a “qualified health benefits plan” it has to offer preventive services, well-baby care, and well-child care with no cost-sharing to the family and the “at least comparable” suggests that nothing covered now would in principal be lost. Those “higher costs in the Exchange” derive from the extension of coverage to the parents and not from any financial barriers to get coverage for the children. To the extent this is a problem it is not one of transitioning kids out of CHIP but instead one of affordability overall. If the services delivered end up the same or better I can't get too worked up by the labeling on the program.


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