More on that HHS QHP-CHIP Comparison

My last blog before maternity leave was on the release of HHS’s certification summary, or the results of the agency’s Congressionally mandated comparison of CHIP with the qualified health plan (QHP) coverage children receive. My first blog since returning to work full time is on the same topic—in late May, HHS’s Office of the Assistant Secretary for Planning and Evaluation (ASPE) released a backgrounder with more details on the earlier analysis.

While this additional detail doesn’t address all of the remaining questions we have (and in fairness, QHP plan level detail and the rage of potential service utilization are not easy to come by!), it does provide more detail on financial risk for families and the study’s methodology. As the earlier summary stated, the vast majority of families in every state have lower out-of-pocket expenditures when their children receive CHIP rather than QHPs, specifically when looking at QHP second lowest cost silver plans. The most notable new detail in this document is state-specific data on proportion of children who would have greater financial protection in CHIP vs. QHPs (see the summary table on Page 9, shown below). As the two right-hand columns indicate, in all but eight of the states examined, 100% of CHIP-eligible children had greater financial protections in CHIP. Seven states had a very small proportion of children (under 1%) whose families would be better off in QHPs. But the biggest exception was Missouri, which ASPE estimates has more than 11 percent of families that would be better off financially with children in QHPs. While Missouri does not have deductibles, coinsurance or co-pays in CHIP, ASPE notes that the state’s much higher CHIP premiums account for their outlier status.

While questions remain, this and other analyses (many of which are detailed in this paper) provide evidence, again, that CHIP most often provides child-specific benefits at a more affordable cost than QHPs. The analysis offers another informative piece of the puzzle as we seek to examine all of the places children receive coverage today and thoughtfully consider what it should look like in the months and years to come to ensure they get the health care they need to grow and thrive well into adulthood. (On that note, if you haven’t yet seen the first paper in our Future of Children’s Coverage series on exchange coverage for kids, check it out here.)

Comparisons of CHIP and QHPs

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