October 23, 2009
Dear Partners,
Last week the Senate Finance Committee passed its health reform bill, becoming the last of the five committees of jurisdiction to do so. The Senate and the House are merging their respective bills with a goal of bringing a bill to the floor of each chamber by next month.
As we mentioned in our last alert, the current version of the Senate Finance bill includes a revised amendment from Senator Rockefeller (D - WV). We are extremely appreciative that Senator Rockefeller continues to make children's health care a priority. His amendment requires states to continue Medicaid for children and CHIP through 2019, although it does not officially reauthorize the program past 2013 or specify how to finance it.
In the short run, maintaining CHIP will provide millions of children with stable, comprehensive coverage in a proven and effective program. In the longer run, we need to consider whether children are better served remaining in CHIP or being covered under the Exchange. The advantage of CHIP is that it is a proven program that provides wide-ranging coverage. The disadvantages of CHIP include that it is a block grant, that states could reduce current levels of CHIP benefits and cost-sharing protections, and that children and parents are in separate programs.
In order to secure the best possible outcome for kids, we need to build on the Rockefeller amendment and restore provisions that were in the bill prior to Rockefeller's adoption to protect kids if they are transferred to the Exchange sometime in the future. Key improvements needed for children are outlined below.
ACTION STEP
There are still several opportunities to continue to improve the bills in the coming months, and we must continue to stress to Members what we would like to see in the final bill. Please contact your Delegation Members and ask them to support the following improvements for children:
- Fund CHIP for at least three additional years past 2013 as part of a transitional process to ensure children are not prematurely moved into the Exchange.
- Reinstate the Stabenow amendment to guarantee that if/when children are moved into the Exchange they will receive benefits and cost-sharing protections at least comparable to what is offered through CHIP.
- Offer EPSDT benefits and additional cost-sharing protection for children up to 250% FPL by combining the Stabenow amendment with language from the Senate Finance Committee Chairman's mark to restructure the CHIP program.
- Expand state CHIP and Medicaid maintenance of effort requirements to ensure that states not only maintain children's coverage levels, but also preserve funding for child health services, provider payments, and enrollment simplifications.
- Improve affordability provisions for families. Children do better when the entire family is covered, but current provisions in the Senate Finance Committee leave low- and moderate-income families with premiums and cost-sharing obligations they may not be able to manage. For more information and talking points on affordability, please see Community Catalyst's paper Common Sense Affordability Protections.
We will continue to keep you updated about the latest developments on children in health reform. As always, please feel free to contact me directly with questions (617-275-2929, arosenthal@communitycatalyst.org).
Sincerely,
Amy Rosenthal
Project Director
