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SAME Act Could Give Alabama Second Chance at Medicaid Expansion

SAME Act Could Give Alabama Second Chance at Medicaid Expansion

Alabama Sen. Doug Jones introduced legislation this week to give a second chance to expand Medicaid to those states that have not yet expanded their programs. The States Achieve Medicaid Expansion (SAME) Act would also give these states another opportunity to receive the same levels of federal funding that was offered in 2010.

“Alabama made a mistake by not expanding Medicaid. If I can give them an opportunity to rectify that, I’d like to do it,” Jones said in an interview with the Montgomery Advertiser. “I think it’s important for us to expand Medicaid in the state to help save our rural hospitals, get better health outcomes in those rural areas and to provide an economic boost in the state. Let’s finish this job and move forward, instead of languishing and letting our Medicaid dollars that we already pay go to other states.”

Originally in 2010, there would have been federal funds to cover the full cost of expansion for three years for those states that expanded their Medicaid program, at which time federal coverage would drop to 90 percent and states would cover the rest. Should the SAME Act pass, full funding would be offered for three years before decreasing to 95 percent funding in the fourth year, 94 percent in the fifth and 93 percent in the sixth. Federal coverage would stand at 90 percent every year thereafter.

The Medical Association remains an advocate for not only fully funding Alabama’s Medicaid program but also agrees with expansion of the program. Medicaid is a state-run program providing health coverage for about 23,000 low-income residents. To qualify for current Medicaid coverage, families with children must have a household income at or below 18 percent of the poverty level. Expanding the program would take that threshold up to 138 of percent the poverty level, offering access to as many as 325,000 Alabamians.

Posted in: Medicaid

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Possible Government Shutdown with CHIP in the Balance?

Possible Government Shutdown with CHIP in the Balance?

Friday, Jan. 19: Government shutdowns are rare, with the last shutdown in 2013 that lasted 17 days. Even though the U.S. House passed legislation that would fund CHIP for six more years, the Senate may not approve the measure. In fact, Congress is facing the possibility of another government shutdown, which could leave health care for more than 9 million children caught in the middle of the fray.

Late Thursday evening the House passed legislation 230-197 to keep the government open for business through Feb. 16. The measure now faces a steep battle with Senate lawmakers as time ticks down to midnight to avoid a full shutdown. It’s been widely reported that conservatives in the House Freedom Caucus largely backed the measure even after being locked in debate with the White House and GOP leaders over concerns of military funding and immigration reform. The legislation also includes a measure to renew the Children’s Health Insurance Program for another six years.

Now with the legislation in the Senate it faces steep opposition by Democrats who appear intent on securing concessions that would, among other things, protect from deportation young immigrants brought to the country illegally as children, increase domestic spending, aid Puerto Rico and bolster the government’s response to the opioid epidemic. Senate Democrats have publicly decried the GOP does not have the votes necessary to pass the legislation.

According to the Georgetown University Center for Children and Families, there are now 11 states in danger of running out of CHIP money by the end of February…a number that will double by the end of March. Complicating matters even more, the Congressional Budget Office has stated that extending CHIP funding for 10 years would save the federal government $6 billion whereas initial estimates were that renewing CHIP funding would cost $8.2 billion.

The CBO adjustment stems from changes Congress has made to the Affordable Care Act making private health insurance more expensive and an increase in federal spending on subsidies for that coverage makes CHIP a better deal in comparison.

A government shutdown means more to medicine than health care for America’s children. It will affect the Centers for Disease Control and Prevention during one of the most dangerous flu seasons in recent history. The National Institutes of Health will be forced to stop enrolling patients in clinical trials. Drug approvals by the Food and Drug Administration will come to a complete stop.

The Medical Association is closely monitoring legislation pertaining to CHIP funding and will report any changes as they occur.

Posted in: Advocacy

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UPDATE: Lawmakers Back to the Drawing Board for CHIP Funding Renewal

UPDATE: Lawmakers Back to the Drawing Board for CHIP Funding Renewal

UPDATED OCT. 12, 2017 — Legislation to renew funding for the Children’s Health Insurance Program has stalled in the U.S. House as lawmakers continue debating how to pay for the program. This is the third delay requested by the Democrats as the lawmakers now work to mark up the legislation to extend funding for critical programs other than CHIP, such as Community Health Centers and to provide an additional $1 billion to Puerto Rico’s Medicaid program.

Both parties agree on the urgency of passing a CHIP bill. Federal funding for the program expired Sept. 30, and the longer Congress delays taking action, the tougher it will be on states.

Eleven states anticipate they will burn through their federal funding by the end of 2017, according to the Kaiser Family Foundation, and 32 states project they will exhaust federal funds by the end of March 2018.

Click here to read House Energy and Commerce Committee Chairman Greg Walden’s Statement on CHIP and Extending Critical Public Health Programs

OCTOBER 6, 2017 — After being unable to come together to meet a Sept. 30 deadline that would have renewed funding for the Children’s Health Insurance Program for five years, lawmakers in Washington were back at the drawing board this week looking for solutions to ensure federal funding for CHIP even though the Senate Finance Committee reached a bipartisan deal in mid-September to extend funding for five years.

Earlier in September, the U.S. Senate Finance Committee reached an estimated $8 billion bipartisan agreement to renew CHIP funding for five years and phase out the 23 percent Obamacare funding bump. States would have maintained eligibility through 2019, and after that there would be no so-called maintenance of effort for children of parents with incomes more than 300 percent of the federal poverty level.

The Medicaid and CHIP Payment and Access Commission has estimated that all states will exhaust their federal CHIP reserves in 2018 without an extension but warns that an extension alone will not be enough.

“If Congress extends funding but does not include the 23 percentage-point increase in the federal matching rate that was provided in the ACA, most states will still face shortfalls, since many assumed continued funding with the enhanced match rate,” it noted.

In Alabama, CHIP funding is split between Alabama Medicaid and the Alabama Department of Public Health. ADPH administers the ALL Kids program, which covers about 83,000 of Alabama’s children, while Medicaid provides covers for an additional 70,000 children.

The Medical Association, the Alabama Chapter of the American Academy of Pediatrics, state lawmakers and a number of organizations advocating for children’s health care petitioned the Alabama Congressional Delegation to support reauthorization of a bipartisan CHIP funding bill before the Sept. 30 deadline. In a letter to the Alabama Congressional Delegation outlining support for CHIP reauthorization, the coalition cited the great strides made possible through CHIP in ensuring children have access to the care they need. As well, any reductions in federal CHIP funding could cause problems for not only Alabama’s ALL Kids program but also children enrolled in Alabama Medicaid.

Posted in: CHIP

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