CHIP Works – What’s next? Carrie Fitzgerald
CHIP Works – What’s next? Carrie Fitzgerald. Children in the Budget: A Little Bit of Background The State Children’s Health Insurance.
Jan 20, 2016
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CHIP Works – What’s next?
Carrie Fitzgerald
Children in the Budget:
www.firstfocus.net
A Little Bit of Background
• The State Children’s Health Insurance Program (SCHIP) was created in 1997 to insure children in families with too much income to qualify for Medicaid and too little to afford private insurance.
• States have the option of providing coverage in CHIP through Medicaid, a separate program, or a combination of the two.
Children in the Budget:
www.firstfocus.net
A Little More Background
• There is also flexibility in benefit design, though benefits must meet certain set standards.
• As in Medicaid, state payments for CHIP qualify for federal matching payments. On average, the federal government pays 70 percent and state governments pay 30 percent of program costs.
Children in the Budget:
www.firstfocus.net
CHIPRA Signed in February 2009
• The five year anniversary of the signing of CHIPRA – February 4th (Children’s Health Insurance Program Reauthorization Act)
Children in the Budget:
CHIPRA 2009
$32.8 billion, 5-year reauthorization Eligibility Changes
– Legal immigrant children and pregnant women
– Low-income pregnant women Outreach and Enrollment
– Express Lane Eligibility– $100 million in outreach and enrollment grants
Benefit Improvements– Dental benefits– Mental health parity
Children in the Budget:CHIP Covers Kids
www.firstfocus.net
Children in the Budget:CHIP Enrollment 2002-2012
www.firstfocus.net
Children in the Budget:CHIP – Where Does It Stand Now?
• CHIPRA funded CHIP until 2013
• The Affordable Care Act authorizes CHIP until 2019 and funds it through FY2015
www.firstfocus.net
Children in the Budget:WHAT IF…
www.firstfocus.net
Children in the Budget:
www.firstfocus.net
What Happens If CHIP Goes Away?
• The Government Accountability Office (GAO) says that two million children will go uninsured due to the kid glitch/affordability test.
• The rest will likely go into plans in the Marketplaces. Those plans may not have the same cost protections, provider networks, and benefits as CHIP.
Children in the Budget:CHIP vs. Exchange Plans: What is Best for Low-Income Children?
CHIP is Clearly Better at This Point
• Benefits – CHIP• Affordability: Premiums/Cost Sharing -
CHIP• Adequacy of Pediatric Provider Networks -
CHIP• Guarantee of Coverage/Entitlement -
CHIP• Family Coverage - Exchanges• Focus on Pediatric Quality of Care - CHIP
Children in the Budget:CHIP Compared to Exchange Plans
*Senate HELP bill requires plan at least equivalent to typical employer-based plan.
CA: 0.980, CO: 0.984, CT: 1.000, DC: 1.000, IA: 1.000, MD: 1.000, ME: 1.000, MT: 0.984, NC: 0.989, NH: 1.000, NM: 1.000, NV: 1.000, NY: 1.000, PA: 1.000, TX: 0.964, WA: 1.000, WV: 0.922
FIGURE 1:
Actuarial Values for Children in 17 State CHIP Programs and 3 Benchmark Plans, 2010 (175% FPL)
Children in the Budget:CHIP Compared to Exchange Plans
FIGURE 3:
FAMILY’S TOTAL EXPENSE TO COVER ONE CHILD IN TOP 10% OF USERS, 2010 (225% FPL)
Senate Finance estimate based on Silver plan. “n/a” indicates states that do not offer CHIP coverage at 225% FPL.
n/a n/a
Children in the Budget:How Can We Protect CHIP?
www.firstfocus.net
Children in the Budget:
www.firstfocus.net
National Health Advocates Working on CHIP Strategy:
– First Focus– Children’s Defense Fund– American Academy of Pediatrics– Children’s Hospital Association– March of Dimes– Family Voices– Georgetown Center for Children
and Families
Children in the Budget:
www.firstfocus.net
February 4th – CHIPRA 5th Anniversary
• Launch Day for Efforts to Renew Funding
• Event with Senator Rockefeller’s (D-WV) Office
• Senator Rockefeller Will File a Bill in Late February or Early March
• Hearing on the Hill in March
Children in the Budget:
www.firstfocus.net
What State Advocates Can Do
• Promote the success of CHIP in your state
• Celebrate the five year anniversary of CHIPRA
• Talk to the press about CHIP stories
• Meet with your congressional delegation about CHIP
Children in the Budget:
www.firstfocus.net
Voters Want to Protect CHIP
Oppose CHIP Cuts
Support CHIP Cuts
Don’t Know
Source: First Focus Campaign for Children, research by Public Opinion Strategies, 2012
Children in the Budget:
www.firstfocus.net
Do What You DO Best!
SOCIAL MEDIA
PRESS EVENTS
OP-EDS , Letters to the Editor
VIDEOS
Events with Your Governor or Congressional Members
Children in the Budget:The Road Ahead: Steps to Achieve Success
• Increase Knowledge: Share research/data, family stories
• Support Agenda: Strong & unified voice
• Build Will: Coalition building, find champions, & communications/messaging
• Take Action/Create Opportunities: Celebrate wins & make/take advantage of opportunities
CoverAll
Kids
CHIPWorks
Protect Child Health
Children in the Budget:Please Keep in Touch
• Send info on what your Governor is saying
• Share info from your congressional visits
• Send us media clips and press coverage
• Ask us for help!!
www.firstfocus.net
Children in the Budget:
www.firstfocus.net
Carrie Fitzgerald202-657-0663
www.firstfocus.net
Thank You!
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