Press Releases
Brendan Daly/Nadeam Elshami
202-226-7616
09/21/2007
Pelosi: Senate, House Announce Agreement to Renew, Improve Children's Health Insurance Program Now
Below is an outline of the agreement, which is designed to target specifically the lowest-income uninsured American children for outreach and enrollment. The agreement does not call for CHIP coverage for children in families at higher income levels. Instead, it reduces Federal matching funds for future coverage of children at higher income levels, and provides incentives to cover the lowest-income children instead. CHIP coverage of childless adults and parents will be phased out to maintain the program’s focus on kids.
Investing $35 Billion in New Funding for CHIP. The agreement reauthorizes the Children’s Health Insurance Program, investing an additional $35 billion over five years to strengthen CHIP’s financing, increase health insurance coverage for low-income children, and improve the quality of health care children receive.
Lowering the rate of uninsured low-income children. The agreement will provide health coverage to millions of low-income children who are currently uninsured. The bill also ensures that the 6.6 million children who currently participate in CHIP continue to receive health coverage. Pending final Congressional Budget Office estimates, the reduction in the number of uninsured children will approach four million children.
Improving Access to Benefits for Children (Dental Coverage/Mental Health Parity/EPSDT). Under the agreement, quality dental coverage will be provided to all children enrolled in CHIP. The agreement also ensures states will offer mental health services on par with medical and surgical benefits covered under CHIP, and protects medically necessary benefits (EPSDT) for low-income children.
Prioritizing children’s coverage. The agreement makes several modifications as it relates to populations eligible for CHIP.
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Pregnant Women: The agreement provides coverage to pregnant women as a new state option as well as preserving the options to cover them through a state waiver or through regulation.
Parents: The agreement prohibits any new waivers to cover parents in the CHIP program. States that have received waivers to cover low-income parents under CHIP will be allowed to transition parents into a separate block grant. The federal match for services to parents covered through CHIP will be reduced.
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Childless Adults: The agreement retains the current law prohibition of waivers to allow coverage of childless adults. Currently covered childless adults will transition off CHIP. For states that have received CHIP waivers to cover childless adults, the agreement terminates those waivers after a one-year period, provides temporary Medicaid funding for already-enrolled adults, and allows states to apply for a Medicaid waiver for coverage.
Providing states with incentives to lower the rate of uninsured low income children. Under the financing structure, states will receive state-based allotments that are responsive to state demographic and national spending trends and allow additional up-front funding for states planning improvements. States that face a funding shortfall and meet enrollment goals will receive an adjustment payment to ensure that no child who is eligible for Medicaid or CHIP is denied coverage or placed on a waiting list. The formula also sets in place new overall caps on federal funding to ensure the program’s expenditures do not exceed the amounts authorized. The agreement provides incentives for states to lower the rate uninsured children by enrolling eligible children in CHIP or Medicaid.
Agreement Replaces CMS August 17th Letter to States. The Congress agrees with the President on the importance of covering low-income children have health coverage while taking steps to address crowd-out and prioritize coverage of lower income children. The agreement replaces the flawed CMS August 17th letter to states with a more thoughtful and appropriate approach. In place of the CMS letter, the agreement gives states time and assistance in developing and implementing best practices to address crowd out. The agreement also puts the lowest income children first in line by phasing in a new requirement for coverage of low-income children as a condition of receiving CHIP funding for coverage of children above 300 percent of the poverty level.
Improving Outreach Tools to Simplify and Streamline Enrollment of Eligible Children. The agreement provides $100 million in grants for new outreach activities to states, local governments, schools, community-based organizations, safety-net providers and others.
Improving the Quality of Health Care for Low-Income
Children. The agreement establishes a
new quality child health initiative to develop and implement quality measures
and improve state reporting of quality data.
Improving Access to Private Coverage Options. The agreement expands on current premium
assistance options for states. The
agreement allows states to offer a premium assistance subsidy for qualified,
cost-effective employer-sponsored coverage to children eligible for CHIP and
who have access to such coverage. It
also changes the federal rules governing employer-sponsored insurance to make
it easier for states and employers to offer premium assistance programs.
Legislative language is currently being finalized, and will be available Monday. The House of Representatives will likely vote on legislation implementing this agreement on Tuesday of next week. The Senate will take up the measure shortly thereafter, to deliver a full renewal of the Children’s Health Insurance Program to the President for signature into law before CHIP’s current authorization expires on September 30.
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Supporting the Bipartisan Agreement to Improve the
Children's Health Insurance Program
Senate Majority Leader Harry Reid (D-Nev.): “This
announcement is a victory for
Senate Finance Committee Chairman Max Baucus (D-Mont.): “Right now, millions of children in
Senate Finance Ranking Republican Chuck Grassley (R-Iowa):
“This legislation will get the Children’s Health Insurance Program back on
track and reclaim precious resources for low-income kids. It breaks the legislative impasse and should
have strong support from both Democrats and Republicans. The bill will enable the Children's Health
Insurance Program to help cover millions more low-income uninsured
children. As far as the size of the
package, it's important to understand that about half of the new money is
needed just to keep the program running, and the rest goes to cover more
low-income kids. The bill is written to
safeguard those dollars. It phases
adults out of the program and tamps down on states covering higher income
kids. It also works to help families to
afford employer coverage.
As part of the compromise between the Senate and the House,
House leaders have agreed to put aside Medicare for the time being so we can
focus on getting health insurance to children.
There are important Medicare issues that need to be addressed before the
end of the year, including the update for Medicare payments to physicians. I expect the Senate to start work on Medicare
very soon, and I look forward to working with Chairman Baucus and members of
the Finance Committee to get the work done.”
House Ways and Means Chairman Charles Rangel (D-N.Y.): “This
bill is a reasonable and compassionate agreement that represents a major
victory for
House Energy and Commerce Chairman John Dingell
(D-Mich.): “This is the product of a
strong, bipartisan agreement and a shared commitment to taking care of
Senate Finance Health Subcommittee Chairman Jay Rockefeller
(D-W.V.): “I am proud we were able to put aside our partisan differences to do
what’s right by our nation’s children. Now, millions more kids will be able to
see a doctor, and have access to life-saving medication, preventative
screenings and basic medical care.
Congress is absolutely committed to sending a bill to the President
before September 30. The fate of these
children is now his moral responsibility. It’s incomprehensible to me that the
President would walk away from low-income children who need health
insurance. I hope he makes the right
choice.”
Senate Finance Health Subcommittee Ranking Republican Orrin
Hatch (R-Utah): “I have been fighting for legislation that will not only
continue the CHIP program, but also cover more low-income kids who are eligible
for CHIP. Today, we are unveiling our bipartisan compromise that accomplishes
those two very important goals. Our proposal is an honest compromise which
improves a program that works for
“That said, I am very sympathetic to what the President is
saying about that CHIP, which has worked so well, should not become a big,
one-size-fits-all government program. I am hoping that he will work with us on
this program because this is a true compromise within the Senate between
Democrats and Republicans, and between the House and the Senate.”
House Energy and Commerce Health Subcommittee Chairman Frank
Pallone (D-N.J.): “Today, Democrats and
Republicans came together to announce a plan that will provide quality health
care coverage to ten million low-income children in our nation. Since its creation, CHIP has helped reduce
the number of children living without health care coverage, but over the last
two years those numbers actually increased.
Today's bipartisan agreement strengthens CHIP so that we can reverse
this troubling trend by reaching out to more kids who are already eligible for
the program. I hope President Bush takes
a serious look at this agreement and reconsiders his veto threat so he does not
turn his back on ten million children.”
Rep. Ray LaHood (R-Ill.): “This is a good bipartisan compromise to help the millions of uninsured children in our country. Whatever financial strains a family may endure, it should have no impact on the type and quality of care their child receives for health related matters. I support this bill and will encourage my Republican colleagues to do the same.”