By Tara Mancini

This week, the Administration reinforced its support for Express Lane Eligibility by including its permanent extension in the proposed FY 2015 budget. As many Say Ahhh! readers know, without further authorization, this effective enrollment strategy is set to expire at the end of September.

Other notable extensions in Medicaid and CHIP include:

• CHIP Performance Bonuses through FY 2015 (including revised eligibility criteria, more on that in the future).
• Transitional Medical Assistance (TMA) through December 2015.
• Medicaid rate increase for primary care providers through December 2015. The proposal strengthens the current program by expanding eligibility to mid-level providers and excluding ER codes.

Similar to last year’s proposal, the president is suggesting that FY 2024 Medicaid DSH allotments be based on states’ actual DSH allotments as reduced by the ACA, rather than pre-ACA levels. The proposal to prevent inflation-based reductions to the federal poverty guidelines also appears again.

Other new proposals of interest include increased state flexibility to provide benchmark-equivalent benefit packages to non-elderly, non-disabled, adults in Medicaid above 133% FPL, accelerating state innovation waivers so that they may begin two years earlier than provided under the ACA, and a five-year collaboration between CMS and HHS’s Administration for Children and Families (ACF) to address over-prescription of psychotropic medications for children in foster care.

Funding Overview

Medicaid: $331.4 billion for current law – This is an increase of 23 billion (~7%) from FY 2014. Legislative proposals add an additional $4.5 billion in outlays, mostly due to the expanded Medicaid rate increase. It also includes the impact of ELE on Medicaid ($20 million in FY 2015, $245 million through FY 2019).

CHIP:  $10,611 billion for current law – This is an increase of $322 million (~3%) from FY 2014. The impact of the permanent extension of ELE on CHIP is estimated to be $10 million in 2015 and 135 million through 2019.

ACA:  $15.5 billion for current law – This is an increase of $11,692 billon, or 3 times more than FY 2014 funding, for provisions related to private health insurance programs and protections. The additional funds are requested for the transitional reinsurance program, risk adjustment, and risk corridors, none of which were funded in FY 2014.  An additional, $1.8 billion is being requested for program management of the marketplace.

While the President’s proposed budget shows ongoing support for building upon the success of strong programs like Medicaid and CHIP, there usually hasn’t been much hope for his recommendations being adopted on the hill. (Still, others, like the Center on Budget and Policy Priorities suggest that it serves as an important blueprint for budget discussions on the horizon.)

For more information, check out the President’s 2015 Budget proposal, and HHS Budget in Brief.