March 2015 Report to Congress on Medicaid and CHIP

MACPAC releases its March 2015 Report to Congress on Medicaid and CHIP at a time of critical change for both of these programs.

The State Children’s Health Insurance Program (CHIP) confronts exhaustion of federal funds, with the last allotments to states being made under current law in fiscal year 2015. MACPAC began analyzing the implications of this scenario in its March and June 2014 reports to Congress, documenting problems with affordability and adequacy of both exchange plans and employer-sponsored insurance for children who would lose CHIP coverage. In those reports, the Commission recommended extending CHIP for two years while these issues could be addressed. The first four chapters of the March 2015 report to Congress follow up on that recommendation in depth.

Meanwhile, Medicaid, which this year marks a half-century of providing access to health care for the most disadvantaged Americans, is expanding coverage in over half of states to a new group of low-income adults. The March report offers perspective on two approaches being tested in Iowa and Arkansas to use Medicaid funds to purchase exchange coverage for the new adult group.

The Commission also looks closely at whether current policies for Medicaid payment of Medicare cost sharing affect access to care for beneficiaries who are dually eligible for Medicaid and Medicare. The report outlines a new payment analysis framework and concludes with an update on the primary care payment increase that expired in December 2014.

Chapters:

• Sources of Coverage for Children If CHIP Funding Is Exhausted
• Affordability of Exchange Coverage for Children Now Covered by CHIP
• Comparing CHIP Benefits to Medicaid, Exchange Plans, and Employer-Sponsored Insurance
• Provider Networks and Access: Issues for Children’s Coverage
• Premium Assistance: Medicaid’s Expanding Role in the Private Insurance Market
• Effects of Medicaid Coverage of Medicare Cost Sharing on Access to Care
• A Framework for Evaluating Medicaid Provider Payment Policy
• An Update on the Medicaid Primary Care Payment Increase