| Plan |
2009 Childrens Health Insurance Program Reauthorization Act H.R. 2 | |
| Date |
January 2009 | |
| Overall Approach |
Publicly-funded health care coverage for low-income children. | |
| Universal Coverage |
No - Provides coverage for 11 million low-income children: 7 million children currently covered by CHIP plus an additional 4 million low-income children who are currently uninsured. | |
| Guaranteed Coverage |
No | |
| Portability |
n/a | |
| Voluntary Employer-Based System |
n/a | |
| New Programs |
n/a | |
| Expansion of Existing Public Programs/Federal Law |
Creates a new performance bonus payment mechanism to offset state costs associated with enrollment outreach and retention activities. Establishes a Child Enrollment Contingency Fund cover state CHIP expenditures beyond the amount allotted. Dental coverage will be provided to all children enrolled in CHIP. Coverage under CHIP will include mental health services to be provided on par with medical and surgical benefits covered under CHIP. Provides state option to cover pregnant women. | |
| Insurance Pool |
N/A | |
| State Responsibility |
Provides states the option to eliminate the 5-year waiting period for low-income uninsured children who are legally in the U.S. Provides state option to cover pregnant women Provides $100 million in grants for new outreach activities to states, local governments, schools, community-based organizations, safety-net providers and others Allows states to offer a premium assistance subsidy for qualified, cost-effective employer-sponsored coverage to children eligible for CHIP Permits states to use eligibility determinations from "Express Lane" agencies as a means to facilitate enrollment in Medicaid and SCHIP Provides additional funding for states planning improvements | |
| Individual Mandate |
N/A | |
| Employer Mandate |
N/A | |
| Private Insurance Mandates |
Subjects participating managed care organizations to child health quality measures for state Medicaid and SCHIP programs set by CMS
Subjects participating managed care organizations to marketing restrictions, required disclosures to beneficiaries, and access and quality standards | |
| Individual Subsidies |
N/A | |
| Individual Vouchers |
No | |
| Employer Subsidies |
Allows states to offer a premium assistance subsidy for qualified, cost-effective employer-sponsored coverage to children eligible for CHIP | |
| Individual Plan/Provider Choice |
No | |
| National Health Board |
N/A | |
| Tax Changes |
$72 billion increase in the federal tax on tobacco products over 10 years | |
| Premium/Co-Pay/Deductible |
Not addressed | |
| Health Quality Improvement |
Authorizes $45 million for new quality child health initiative to develop and implement quality measures and improve state reporting of quality data.
Authorizes a demonstration project to reduce childhood obesity | |
| Information Technology / Electronic Medical Records |
Establishes a program to develop a model electronic health record for Medicaid and SCHIP beneficiaries | |
| Individual Responsibility for Health and Lifestyle |
N/A | |
| Preventive care |
Not addressed | |
| Transparency |
Establishes a new quality child health initiative to develop and implement quality measures and improve state reporting of quality data. | |
| Drug Reimportation |
N/A | |
| Medicare Rx Drug Price Negotiation |
N/A | |
| Medical Personnel Education |
N/A | |
| Mental Health Parity |
Yes | |
| Other Provisions |
No new waivers to cover parents in the CHIP program will be allowed. States waivers will be allowed to transition parents into a separate block grant. Reduces federal match for services to parents covered through CHIP Retains current law prohibition on waivers for coverage of childless adults. Childless adults currently covered will transition off CHIP Restricts states' matching rate for coverage of children in families with "effective family income" higher than 300% FPL ($63,600 for a family of four in 2008) to the lower Medicaid match rate, rather than the enhanced SCHIP federal match Prohibits HHS from approving any new state Health Opportunity Account demonstrations under the program | |
| Cost |
$73.3 billion over 10 years | |
| Cost Containment |
Establishes new overall caps on state allotments of federal funding | |
| Financing |
Fully offset over the five and ten-year budget window by raising the federal tax on tobacco products and closing a loophole in federal law whereby physicians can refer patients to facilities they own. | |
| Source |
"Bill Summary, Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA)," House Committee on Energy and Commerce, January 2009
"H.R. 2, Children's Health Insurance Program Reauthorization Act," House Republican Conference, Jan. 14, 2009
"H.R. 2, Children's Health Insurance Program Reauthorization Act," Congressional Budget Office, Jan. 13, 2009 | |
