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Children and National Health Reform

July 20, 2009

New information is coming out daily from D.C. and here are updates pertaining to CHIP and Medicaid in the current health care reform bills:

Senate News: HELP Committee passed bill out of committee last week.

Senate Finance Committee still has not dropped legislative language, maybe by Wednesday evening before President Obama’s national address. This committee  is working on a strong bi-partisanship bill.

House News: Education & Labor, and Ways & Means both passed their versions of the bill out of Committees last week,

Energy & Commerce is still deliberating. The strong Blue Dog presence in this committee is making passage more difficult. Markups continue today, this afternoon.

Expected Amendments in E&C Committee:

From  Congressman Rush (D-IL): E&C

1) Simplify and streamline the process to have more children covered. This comes from lessons learned from states.

2) Assure EPSDT benefits in Exchange and make sure all kids in CHIP have EPSDT benefits    (Education & Labor passed the amendment on EPSDT for all kids in the Exchange last week. This is a good amendment that CFPC supported.)

3) Affordability protections using existing Medicaid elements such as no premiums for those under 150% of FPL and 5% Out of Pocket max for children in CHIP.

From Congresswoman DeGette (D-CO): E&C

Allows a “Do No Harm” attitude with respect to kids entering into the Exchange, protecting them to make sure that the Exchange will be just as good, if not better, than current CHIP. There is much concern about kid’s protection in the Exchange if children health plans are solely going to be provided by it. This amendment will provide a time period before CHIP expires in 2013 during which the Secretary of Health and Human Services will submit a report either recommending a reauthorization of CHIP or moving kids entirely into the Exchange.  The goal is to keep kids out of the Exchange until we can assure that their coverage, cost protections, and access will be as good or better than now.
These amendments still have to be scored by CBO and if they are too expensive they will be difficult to pass due to strong Blue Dog presence in E&C, as well as on the floor.  CFPC supports these amendments and has asked Representative Bruce Braley , the Iowa member on Energy and Commerce, for his support as well.
First Focus commissioned an actuarial study that will evaluate 15 current CHIP plans versus the Senate and House Bills to lay appropriate groundwork for effective plans and benefits for kids.  If we need to show what kids get now, and how the Exchange needs to hold kids harmless, we will be prepared.

Additionally, the bills still have all adults eligible for Medicaid up to 133% FPL. You may have heard that the National Governor’s Association does not support this because they fear having to pay for some of it with state dollars. However, the bills read that the federal government will cover 100% of the cost for the first few years, hopefully while state budgets stabilize.

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