It’s hard to believe it was just last month when Congress passed and President Obama signed the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, which extended CHIP funding for two additional years with no major structural or program changes. It funds the ACA’s 23%-point bump, extends CHIPRA’s child health quality provisions and outreach/enrollment grants, and does all of this without rolling back coverage for any kids. Since its passage, we’ve received a number of questions about what’s in the new law (and, as importantly, what’s not!), so we put together a brief that will hopefully answer the basics as well as your detailed questions, such as:
What expenditures “count” for the 23 percentage-point match increase?
MACRA fully funded the ACA’s increased CHIP match rate through 2017. In general, the bump applies to any expenditures allowable under the regular CHIP match rate. The only exclusions are matching rates that were already above the CHIP matching rate levels (e.g. translation and interpretation services). (The appendix of the brief offers a chart with the regular CHIP Enhanced rate as well as the EMAP + 23% points for reference.)
But wait – MAGI pushed our state’s CHIP eligibility level above 300% FPL, does that exclude the higher match?
Nope. CHIPRA’s limit on CHIP’s matching rate—and the ACA’s 23% point bump— in effect does not apply to any state with FPL levels above 300%. It would only apply to states that post-CHIPRA (March 2009) expanded eligibility above 300%. This does not apply to MAGI-converted income levels.
What else is in the new law related to kids and families?
So glad you asked! Other good stuff includes:
- Extension of funding for home visiting programs, family-to-family information centers, and community health centers
- Permanent authorization of Transitional Medical Assistance.