Casey Pushes for Legislation that Would Extend Critical Health Insurance Program for Nation’s Children Through 2019

Some in the House, Senate Considering Cuts to Program that Covers 271,000 PA Kids / County by County Data Shows Impact of CHIP Across PA / Long Term Extension Would Give Families Security, Help States Plan Budgets

Casey Pushes for Legislation that Would Extend Critical Health Insurance Program for Nation’s Children Through 2019

Washington, DC- With funding for the Children’s Health Insurance Program (CHIP) set to expire this year, U.S. Senator Bob Casey (D-PA) pushed for legislation that would extend this critical program that aids millions of children across the nation. Some in the Senate and the House of Representatives are advocating cuts to CHIP, which helps 271,000 Pennsylvania children get healthcare each year. Casey highlighted county by county data showing the impact of CHIP across Pennsylvania and make the case that a long term extension will give families additional security and help states plan their budgets.   

“CHIP is an essential lifeline for millions of families across the nation and it’s critical that we extend the program through 2019,” Senator Casey said. “CHIP is a commonsense program that works. The efforts of both Democrats and Republicans should be focused on strengthening CHIP instead of contemplating cuts as some in the House and Senate are proposing.”

County by county data for current CHIP enrollment in Pennsylvania in February 2015 can be found here:

The Protecting & Retaining Our Children’s Health Insurance Program Act (PRO-CHIP) extends funding for the Children’s Health Insurance Program (CHIP) through fiscal year 2019, protecting coverage for over ten million children and helping families retain a sense of security by ensuring their children maintain access to affordable, comprehensive care. Passing this legislation quickly would also provide much-needed budget predictability to states so they can properly plan and avoid gaps in health care for vulnerable children. 

Allowing funding for CHIP to expire would be a huge step backward for children’s health and for our nation. Since 1997, CHIP has been a lifeline to millions of children and families in every state across the country. Under current law, no new CHIP funding is available after fiscal year 2015, even though the program itself remains authorized. Failure to extend funding for CHIP would leave millions of children uninsured or at risk of becoming uninsured. It would also mean a significant increase in cost-sharing for services, out-of-pocket costs for families, and benefit restrictions for children.

Nearly forty governors – Democrats and Republicans – are urging Congress to extend CHIP funding to give states the certainty and predictability they need to craft state budgets. Families and states are relying on Congress to extend CHIP now so they can plan for their children and citizens. This bill would accomplish this by extending CHIP in the following specific ways:

  • CHIP Funding and Allotments: Continues annual CHIP funding for states for four years, through fiscal year 2019.
  • Child Enrollment Contingency Fund: Maintains the Contingency Fund through fiscal year 2019 to protect states if they experience a shortfall in CHIP funding. The Fund is only available to states when they experience a shortfall. If a state is projected to experience a shortfall, the state would receive funding in the projected shortfall amount.
  • Performance Incentive Program: Extends the CHIP performance incentive program through fiscal year 2019 and updates the list of qualifying options. In order to qualify for an incentive payment, states must implement four out of eight possible options. The criteria include: (1) continuous eligibility for children; (2) express lane eligibility; (3) presumptive eligibility for children; (4) premium assistance; (5) elimination of waiting periods; (6) automated cost-sharing; (7) real-time eligibility determinations; and (8) elimination of premiums or lock-out periods.
  • Qualifying States Option: Preserves the current qualifying states option through fiscal year 2019. Some states provided coverage to now CHIP-eligible children prior to the original enactment of CHIP in 1997. The qualifying states option enables these states to access CHIP funding to continue covering this population.
  • Pediatric Quality Measures Program: Continues ongoing efforts under the Pediatric Quality Measures Program (PQMP) to develop and refine pediatric quality measures.  Given the role of Medicare in quality measurement and reporting, most nationally-endorsed quality measures are adult-focused and may not be designed to assess the quality of care children receive. The PQMP serves a vital role in developing and strengthening pediatric quality measures used by public and private payers.
  • Demonstration Projects: Extends the Childhood Obesity Research Demonstration (CORD) through fiscal year 2019. CORD aims to encourage better nutrition and physical activity behaviors where children live and learn. Also includes up to 10 new grants under a demonstration for improving the quality of children’s health care through the use of health information technology.
  • Outreach and Enrollment Grants: Extends grants previously available under CHIP that enable state and local governments to address barriers to enrollment.
  • Streamlined Eligibility Determinations: Maintains the express lane eligibility option and extends state ability to use cross-program information to simplify eligibility determinations through fiscal year 2019 for states that want to streamline their eligibility and enrollment processes.