S.873: Stabilize Medicaid and CHIP Coverage Act of 2019

Overview

Each year, many Americans who are eligible and enrolled in Medicaid or CHIP experience coverage disruptions. The average Medicaid enrollee is covered for 3/4ths of the year. Disruptions in coverage can increase medical costs, as individuals substitute preventive care with emergency care. Additionally, it can increase administrative costs due to unnecessary disenrollment and re-enrollment. Disruptions occur because (1) some states have renewals more than once a year creating excess paperwork for enrollees and increasing the likelihood of missing enrollment deadlines and; (2) Short-term income increases, such as overtime pay, can cause individuals to lose their eligibility, even though their ability to afford medical care has not changed.

S. 873 would eliminate disruptions in healthcare coverage by mandating continuous 12-month eligibility for Medicaid and CHIP. Additionally, this bill rewards states that decrease coverage disruptions among specific groups. Overall, the legislation would –
 Ensure Medicaid and CHIP enrollees remain eligible for coverage for 12 months from the date eligibility is determined;
 Eliminate waiting periods for all CHIP applicants;
 Require states to publish enrollment and retention data annually. These reports would include retention rates for children, adults over the age of 65, individuals with disabilities or blindness, and parents/caretaker relatives of children under 19 and;
 Award bonuses to states that implement at least three approved strategies to reduce coverage disruptions and demonstrate improved retention for each of the groups listed above.

H.R. 1879 is the House companion bill.

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Talking Points

  • Disruptions in medical care compromise the well-being of children, older adults, people with disabilities, and many others within our communities.
  • Administrative burdens can deter those eligible for programs that ensure well-being from enrolling.
  • The Stabilize Medicaid and CHIP Coverage Act would decrease coverage disruptions for Medicaid and CHIP enrollees.
  • The Medicaid and CHIP Payment and Access Commission (MACPAC), which was established to review both programs, has previously recommended eliminating all CHIP waiting periods and expanding the continuous 12-month eligibility option.
  • The National Assembly supports S. 873 because continuous healthcare coverage ensures the well-being of all individuals and allows everyone to reach their full potential. Moreover, increasing access to needed services benefits all communities.

Our Stance

Support

Priority

Medium

Bill Number

S.873

Date Introduced

March 26, 2019

Committee

Senate Finance Committee

Bill Status

Introduced or Prefiled