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Ten Child Health Related Provisions in the Manager’s Amendment

December 21, 2009

The Manager’s Amendment was passed early this morning, adding significant changes to the Senate health care bill.  Ten exciting provisions around children’s health include:

1.  Insurers can no longer deny coverage to children because of pre-existing conditions.  This would go into effect immediately for children instead of 2014 for adults.

2. Extend funding for CHIP for another two years.  The CHIP re-authorization of 2009 legislation had funding end in 2013, but now funding is available until September 2015.  This will protect children by keeping them in the children-focused insurance program for longer, instead of being shifted into other, newly established reform programs.

3. States must continue maintenances of effort for Medicaid and CHIP or else lose out on federal funding for Medicaid.  The current levels, eligibilities, and enrollment procedures for children above 133% of the federal poverty line must be maintained through fiscal year 2019.  This will help make sure that even during current fiscal shortfalls in states, child health coverage and children public insurance will stay a top priority.

4. While children could eventually move into Insurance Exchanges (because no federal funding is given to CHIP after 2015), there will be a screening process first to see if children are eligible for Medicaid.  If eligible, children will be enrolled in Medicaid, if not eligible, then the state must make sure that comparable coverage is instituted for children to move into the Exchange.

5. The Secretary of the Department of Health and Human Services will review and certify Exchange plans to make sure CHIP-comparable benefits and comparable cost-sharing procedures are in place.  The exchange plans must have affordable and child-only plans.

6. More funding for CHIP enrollment and renewal activities.

7. Creates a public “buy-in” option for state employees’ children in CHIP.

8. Allows children to stay on their parents’ health insurance plans until 26 years old.

9. Develops and improves children-specific quality priorities, quality measurements, and quality reporting for care.

10.Invest in preventive and wellness programs and services to encourage effective healthy behaviors that prevent illness and disease. Make sure all children have access to such programs under their health insurance plans.

If you like, you can check out the Center for Children and Families at Georgetown University and Every Child Matters Education Fund for more information.

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