On Tuesday, MACPAC released a comment letter to the Chairman and Ranking Members of the Senate Committee on Finance and House of Representatives Committee on Energy and Commerce. In the letter, commissioners urge Congress to extend funding for CHIP quickly and cleanly for two more years and reiterate their support for the program. The MACPAC letter illustrates the effect that failing to extend CHIP funding would have on children.  It also emphasizes the importance of acting quickly stating: “Absent congressional action, states will soon begin taking the necessary steps to discontinue their programs, including notifying enrollees.”

Extending CHIP funding has the support of Republicans and Democrats in Congress, CHIP directors, state Governors, the President, and other advocates. The message to Congress is clear: extend CHIP and do it quickly to reduce the administrative burden on states and cleanly to ensure continuous coverage for children and families. The letter’s key points include the following:

Without CHIP, Some children will become uninsured and have more limited access to care.

If CHIP is not extended, MACPAC estimates that 3.7 million children would lose coverage through separate CHIP programs in FY 2016. One third of those children, or 1.1 million children, would become uninsured.

Families who lose coverage may face much higher premiums and cost-sharing through employer-based coverage or marketplace coverage, leading some families to forego coverage or care.

Without additional certainty on CHIP funding, states will face undue administrative burdens.

Without the guarantee of federal CHIP funding, states will have to consider ending separate CHIP programs and maintaining CHIP-financed Medicaid expansion at the lower Medicaid matching rate. In planning the administrative and operational processes necessary to transition children from CHIP to other sources of coverage, states will face four critical action steps –

• decide whether to use state funds to continue coverage for children enrolled in separate CHIP programs;
• notify families about changes to their CHIP coverage,
• update eligibility and enrollment systems to reflect the loss of or changes to CHIP, and
• adjust CHIP managed care contracts.

Maintain CHIP’s policy structure to minimize disruptions in coverage for children.

Without explicitly naming the Republican discussion draft bill to extend CHIP, MACPAC recommends a CHIP extension that allows states to operate their CHIP programs as they run today. MACPAC reiterated recommendations detailed in prior reports to:

• Allow 12-month continuous eligibility
• Eliminate CHIP waiting periods
• Eliminate premiums for children below 150% of the FPL
• Permanently extend express lane eligibility (ELE)
• Provide continued funding for health care quality measures
• Extend contingency fund authorization

The rate of children’s uninsurance is stagnating and recent reports confirm that this trend has continued through 2014. If CHIP funding is not extended or if the program’s structure is altered significantly, states will experience significant barriers to maintain stable coverage for children.