Save Current Medicaid and CHIP Requirements
to Protect Kids!
We have good news and some bad news. The good news is that, in 2010, the number of uninsured children in the United States was one of the lowest in over a decade—about 7.3 million children were uninsured. Of course, Illinois’s rates of child uninsurance are even lower, thanks to the All Kids program. The Affordable Care Act has the potential to cut the number of uninsured children even further to 4.2 million (still too many uninsured children, but improving!). The expected decreases in uninsured children depend significantly on the states’ continuation of Medicaid and Children’s Health Insurance Programs (CHIP) coverage.
The bad news is that some lawmakers are proposing legislation that will eliminate or greatly reduce Medicaid and CHIP. Without this coverage, the level of uninsured children might actually rise—the exact opposite of what the Affordable Care Act is intended to accomplish. Eliminating Medicaid and CHIP for families above 138% of the federal poverty level would gut the Affordable Care Act’s goal of insuring our nation’s children—these programs must continue in full force in order to offer affordable insurance to young Americans.
Under the Affordable Care Act, children and families with incomes under 138% of the federal poverty level will be covered under expanded Medicaid eligibility provisions. dults over the Medicaid threshold will be expected to obtain coverage for themselves through either the benefits exchanges or traditional employer-provided coverage and will be provided tax credits to make coverage more affordable.
However, as the law currently stands, children in families between 138% and 400% of federal poverty level will continue to be eligible for Medicaid and CHIP due to congressionally mandated “maintenance-of-effort” (MOE) requirements. These requirements dictate that states maintain their existing eligibility, application, and renewal procedures requirements for children until October 1, 2019. his means that states cannot scale back coverage in order to save money, nor can they enact more onerous enrollment procedures.
Unfortunately, some lawmakers are calling on Congress to roll back those MOE requirements. If they are successful, states looking to balance their budgets will surely be tempted to make cuts in this area and force vulnerable children off Medicaid and CHIP. This would be a disaster for the health of our nation’s children. If states are allowed to discontinue their MOE requirements, an estimated 7.9 to 9.1 million children would be uninsured.
If this happens, some families without employer-provided coverage will be eligible for tax credits and purchase coverage for the children on the benefits exchanges. Others will be able to obtain affordable employer-provided coverage.
However, not all families will be able to take advantage of these options. Children of all ages and races will experience higher rates of uninsurance without CHIP and Medicaid, despite the availability of exchange or employer-based coverage intended to replace those programs. For various reasons, the exchanges may be too expensive or unavailable to these families, leaving children without options for insurance.
The Affordable Care Act is a vital piece of legislation that has the potential to cut the number of uninsured parents and children by millions if it is implemented properly. We cannot skimp on providing coverage for children. Although the government could save some money by eliminating Medicaid and CHIP coverage for families over 138% of the federal poverty level, a decision to do so could leave millions of our most vulnerable uninsured. Medicaid and CHIP must continue at full strength, since these are vital lifelines for millions of uninsured children and high-quality and affordable coverage for our nation’s youth.
