House Releases Health Reform Bill: A Quick Look at the Child and Family Provisions – Say Ahhh! A Children’s Health Policy Blog

Yesterday the House Leadership released its merged health reform bill, The Affordable Health Care for Americans Act of 2009. It includes some noteworthy changes with respect to kids and families from the previous version of the bill.  Here are some highlights:

  • Raises the mandatory Medicaid threshold from 133% to 150% FPL.  CBO estimates that by 2019, 15 million new individuals will receive Medicaid as a result of the expansion.  Also maintains current state Medicaid eligibility levels above 150% (which also now includes children in CHIP-funded Medicaid expansions).
  • Continues full federal funding up to 150% FPL for all adults and newly eligible parents in 2013 and 2014–but, starting in 2015, the percentage will decrease to 91%. In a significant move for states, it extends (from the end of 2010 until June 30, 2011) the ARRA provision that increased Medicaid’s federal matching rate for states.
  • Still allows CHIP to expire at the end of 2013 (with states maintaining current coverage levels until that time.) States with separate CHIP programs will shift children at income levels below 150% FPL to Medicaid, for which they will receive their current CHIP-enhanced match.
  • Expects remaining CHIP children will be enrolled in Exchange the day after CHIP expires on December 31, 2013. Also revises language that originally precluded this transfer until children received comparable coverage. Now the Secretary of HHS will report to Congress on how to ensure that the Exchange coverage (benefits and cost sharing) is comparable to an average CHIP plan and that appropriate transfer procedures exist.
  • Continues to provide subsidies to people up to 400% FPL and establishes new out-of-pocket caps. But decreases the subsidy levels across the income levels. For example, a person at 250% of FPL will now contribute up to 8% of their income, instead of 7%.
  • Maintains increases in Medicaid’s payment rates for primary care services. Starting in 2012, rates would rise to those for Medicare with the federal government covering most of the increased costs.

Look out for our new summary of the legislation in the coming days.

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