MACPAC-LetterOn April 11th, the Medicaid and CHIP Payment and Access Commission (MACPAC) voted unanimously to recommend to Congress that CHIP be funded for only two years, and sunset in 2017. (MACPAC is a non-partisan, federal agency charged with providing policy and data analysis to the Congress on Medicaid and CHIP, and making recommendations to Congress and the Secretary of the U.S. Department of Health and Human Services, and the states on a wide range of issues affecting these programs.)

The intention of MACPAC is for children to move from CHIP coverage into exchange coverage through the Affordable Care Act (ACA). The Commissioner’s deliberations before the vote made it clear they believe there are very specific issues that must be fixed prior to children transitioning from CHIP. They agreed that exchange coverage must be affordable and adequate for children and that these problems be addressed:

  • Eligibility concerns, including fixing the “kid glitch” that could affect two million children
  • Issues with respect to cost-sharing and premiums, overall affordability
  • Benefits, including dental, and provider networks must be adequate for children
  • Financing implications both at the state and federal levels be resolved

In response to their recommendations, First Focus sent this letter to the Commissioners. While we understand and fully support MACPAC’S efforts to ensure that coverage provided through the ACA is appropriate to meet the needs of children, we believe it is critical to adopt a policy that we “do no harm” and not gamble with health coverage for children. As such, we fundamentally disagree that setting an arbitrary sunset date for CHIP is an effective way to achieve these important goals. We should consider moving children to the exchange plans only when that child health coverage is fully comparable and equivalent to what is offered to children through CHIP. We want to be sure that children are not moved out of CHIP before all of the issues are addressed and we can be sure that children won’t be worse off.