As we contemplate what’s ahead for children’s coverage— CHIP most urgently— it is instructive to know what issues are being weighed by the Medicaid and CHIP Payment and Access Commission (MACPAC), created by CHIPRA. Of course, MACPAC’s June report made clear that CHIP funding should continue until availability, affordability, and quality of coverage in the marketplaces are sufficiently addressed—a minimum of two years, but longer if necessary.

Earlier this month, MACPAC put out a request for stakeholder input on the future of children’s coverage, due Friday, December 19^th. It asks respondents to address four topics, weighing in on necessary policy changes that will ensure marketplace coverage is accessible, affordable and appropriately designed to meet children’s developmental needs. (Say Ahhh! readers know that evidence continues to mount that CHIP exceeds marketplace coverage in these areas, see here, here, and here.) These four topics are:

1.  Affordability of coverage and out-of-pocket costs, including premiums and cost sharing (e.g., copayments, coinsurance, and deductibles) in exchanges
2. Adequacy of covered benefits in exchanges
3. Adequacy and appropriateness of provider networks for children in exchanges
4. Greatest area(s) of concern with transitions between coverage in Medicaid, CHIP, exchanges, or employer sponsored insurance, and options to safeguard against them

But wait! While we should certainly be looking at policies necessary to improve exchanges for kids, a core assumption of the request seems to assume a world without CHIP. Yet a fundamental policy change necessary right now is to extend funding for CHIP for at least four years—more if necessary. Four-plus years will ensure any transition to other coverage sources is thoughtful, careful, and systematic, allowing states and HHS enough time to ensure no child is left with less affordable or less comprehensive coverage than they have today.

So we at CCF will be responding to this request (and hope you will too!), addressing each question thoughtfully but also taking every opportunity to underscore the fact that in order for children’s coverage to remain successful, CHIP must remain strong and stable for the foreseeable future. (And, as always, we are happy to share our work with any partners that would like to adapt for their own responses.)

We can’t afford to take CHIP for granted even as we work at improving and protecting other critical coverage sources for kids. So this Thanksgiving and well beyond, let’s continue to give CHIP the thanks it deserves.