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Posts in "Children"

February 23, 2015

Mulling Implications of Not Renewing CHIP Funding

The State Children’s Health Insurance Program (CHIP) is poised for a possible rocky-road ahead if Congress does not renew funding later this year. The CHIP program is a means-tested program providing health insurance coverage to low-income children and pregnant women. It is a joint project to the federal government and the states. Federal regulations set basic requirements and the states can design their own programs. In 2013 CHIP enrollment totaled 8.4 million and federal and state CHIP expenditures totaled $13.2 billion.

Federal funding for the CHIP program expires on Sept. 30, 2015 and funding renewal is a high bipartisan congressional priority but debate on a re-authorization bill is likely to extend to close to the deadline. If lawmakers are unable to agree on a renewal bill, the portion of federal CHIP funding assigned to the ongoing effort to expand Medicaid will be covered through regular Medicaid funding, but other state CHIP programs are subject to funding restrictions covered by ‘maintenance of effort’ rules included in the Affordable Care Act. The program maintenance rules require states to maintain current eligibility levels for CHIP children.

The Congressional Research Service recently provided lawmakers with a report (CQ subscription) describing the impact to maintenance of effort rules for ongoing CHIP programs if funding expires in September. The report notes:

The states are provided a couple of exceptions to the MOE requirement: (1) states may impose waiting lists or enrollment caps to limit CHIP expenditures, and (2) after September 1, 2015, states may enroll CHIP-eligible children in qualified health plans in the health insurance exchanges. In addition, in the event that a state’s CHIP allotment is insufficient to fund CHIP coverage for all eligible children, a state must establish procedures to screen children for Medicaid eligibility and enroll those who are Medicaid eligible. For children not eligible for Medicaid, the state must establish procedures to enroll CHIP children in qualified health plans in the health insurance exchanges that have been certified by the Secretary of Health and Human Services to be “at least comparable” to CHIP in terms of benefits and cost sharing.

By Paul Jenks Posted at 11:58 a.m.
Children, Insurance

February 4, 2015

Vaccines: From Flu to Measles

A House subcommittee hearing on Tuesday originally set to focus on this year’s mismatched flu vaccines quickly expanded toward a discussion on a developing outbreak of measles caused by a reluctance parents to seek vaccination for their children.  Ironically, the measles vaccine is far more effective than this year’s flu vaccine. The CDC estimates that getting the vaccine only reduced by 23 percent the chances that a person would get a laboratory-diagnosed confirmation of flu. However, a single dose of the measles-mumps-rubella vaccine will allow more than 95 percent of people to develop immunity to all three viruses and a second dose gives immunity to almost all who didn’t respond to the first dose.

The distrust of the more effective measles vaccine now hangs over a measles outbreak that has affected more than 100 people. The Economist magazine this week critiques geographically concentrated groups of anti-vaccine supporters for opting out of the measles vaccine and opening up the wider general population exposure to measles.

Additional congressional hearings are likely specifically on the measles vaccine and vaccination concerns and a Senate panel has already slated a session for next week. Meanwhile, House Speaker John A. Boehner, R-Ohio, responded on Tuesday about possible congressional action on vaccines: “I don’t know that we need another law. But I do believe that all children ought to be vaccinated.” Separately, a White House spokesman reiterated, “parents across the country have a responsibility to get their kids vaccinated against the measles.”

By Paul Jenks Posted at 7:43 a.m.

January 22, 2015

Medicaid Programs Face Congressional Renewal Pressure

Several Medicaid and Children’s Health Insurance Program (CHIP) payment elements are subject to congressional action – or inaction this year. Funding for CHIP, which provides health coverage to more than 10 million children and teens, is set to expire in September 2015. If Congress does not provide a fresh injection of cash, 2 million people enrolled in the program may not be eligible to receive coverage from Medicaid, the federal-state health program for the poor, or through health care law insurance exchanges.

The Affordable Care Act allowed the program to continue through 2019 but only authorized funding for it through Sept. 30, 2015. Democrats last year eyed possible action on a renewal bill before the end of the last year. However, Republicans, seeking possible changes to the program, were reluctant to push for a renewal so far ahead the September 31, 2015 expiration. Separately, a temporary Medicaid primary care physician payment increase promoted by the 2010 health law and designed to match physician payments with Medicare rates expired on Dec. 31. Physician groups are seeking congressional action to extend the higher rates and a retro-active adjustment for current payments.

By Paul Jenks Posted at 7:55 a.m.
Children, Medicaid

December 12, 2014

Congress Keeps Tabs on “Three-person Embryos”

A fertility technique that can produce “three-person embryos” to prevent women from passing on rare genetic diseases has drawn the attention of  lawmakers who set the budgets for federal agencies including the Food and Drug Administration.

At issue is mitochondrial manipulation, in which genetic material from one woman can be moved into the egg of another. This technique has been developed to help women who otherwise would risk passing on rare mitochondrial diseases to their children, but there’s some thought that it also may aid older women seeking to become mothers.

Full story

November 26, 2014

House Panel Set to Begin Work on Children’s Health Insurance Program Renewal

Senate Democrats, who hold enough votes next year to stall consideration of controversial measures, will likely block action Republican-led action on contentious health topics — particularly regarding the Affordable Care Act. President Obama also can halt any measures with a presidential veto.

However, the renewal of a significant, federally funded health care program could entice some bipartisan compromises. Funding for the Children’s Health Insurance Program (CHIP) is due for congressional renewal prior to the Oct. 1 start of the new fiscal year. Next week, a House Energy and Commerce Committee panel opens up a discussion on renewal options. The hearing is the next step in mulling options for the program, which began in August with a bicameral committee request for suggestions from state governors. The CHIP program has seen rapid growth. Enrollment has surged by 32 percent since 2005 and federal spending has increased 45 percent. Last month, the Pew Charitable Trusts offered a 50-state review of CHIP enrollment and spending.



By Paul Jenks Posted at 9:04 a.m.

October 1, 2014

On the Move in Health: Ami Gadhia

Ami Gadhia

(Source: Consumers Union)

The American Academy of Pediatrics, an organization of 62,000 pediatricians, has hired Ami Gadhia as an assistant director in its department of federal affairs, where she will work on a variety of child health issues.

Fast facts about Gadhia:

  • She was previously a senior policy counsel for Consumers Union, the policy and advocacy arm of Consumer Reports, where she focused on auto, food and product safety issues.
  • Part of Gadhia’s role at Consumers Union was to testify before congressional committees, such as the House Energy and Commerce Committee on policy issues within her purview.
  • Some of the issues that Gadhia will focus on at AAP include preventing child abuse and neglect, improving the foster care and adoption system, and addressing toxic stress.
  • Gadhia is gearing up for the reauthorization of the Child Abuse Prevention and Treatment Act, which she hopes Congress will take up next year.
  • She started work at AAP in early July.

Gadhia says her work at Consumers Union prepared her well for work on a broad portfolio of issues at APP: “[I’m] used to juggling different agencies, different committees and jurisdictions.”

A profile of Gadhia appeared in the Sept. 29, 2014 issue of CQ Weekly.

August 1, 2014

Next Year’s Battle: CHIP Funding

At this time next year, a major battle will be brewing in Congress over the renewal of funding for the State Children’s Health Insurance Program.

Full story

July 8, 2014

HHS Agency Tangles on the Border

The White House today will unveil an emergency spending request to primarily address a child migration crisis on the southern border. The current deluge of unaccompanied children at the border is largely portrayed in the media as an immigration enforcement policy crisis, but the issue also impacts programs and spending for a quiet branch of the Department of Health and Human Services, the Administration for Children and Families (ACF).

Full story

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