public-policy article

Bill Highlight: Stabilize Medicaid and CHIP Coverage Act of 2019 (S. 873)

June 28, 2019

By Carrie O’Foran

Each year, many Americans who are eligible and enrolled in Medicaid or the Children’s Health Insurance Program (CHIP) experience coverage disruptions, which are periods of time when Medicaid or CHIP recipients lose their insurance. Disruptions occur because some states have renewals more than once a year, creating excess paperwork for enrollees and increasing the likelihood of missing reenrollment deadlines. Additionally, short-term income increases, such as overtime pay, can cause individuals to lose their eligibility even though their ability to afford medical care has not changed. The average Medicaid enrollee is covered for 3/4ths of the year. Disruptions in coverage can increase medical costs, as individuals substitute preventive care with emergency care. It can also increase administrative costs due to unnecessary disenrollment and reenrollment.

Bill Details

In late March, Sen. Sherrod Brown (D-OH), along with cosponsors Sen. Elizabeth Warren (D-MA), Sen. Tammy Baldwin (D-WI), and Sen. Sheldon Whitehouse (D-RI), introduced the Stabilize Medicaid and CHIP Coverage Act of 2019 (S. 873).

This bill would eliminate disruptions in healthcare coverage through several mechanisms. First, it would mandate continuous 12-month eligibility for Medicaid and CHIP. Applicants would remain eligible for coverage for 12 months from the date eligibility is determined. It would also eliminate waiting periods for all CHIP applicants. Currently, some states “require children to be uninsured for up to 90 days” before they can initially enroll in CHIP. These “period[s] of uninsurance” are called waiting periods. In addition, states would be required to publish enrollment and retention data annually, including specific retention rates for children, adults over the age of 65, individuals with disabilities or blindness, and parents/caretaker relatives of children under 19. Finally, S. 873 would award bonuses to states that implement at least three approved strategies to reduce coverage disruptions and demonstrate improved retention for each of the groups listed above.

Impact on Human Services

Disruptions in medical care compromise the well-being of children, older adults, people with disabilities, and many others within our communities. Administrative burdens can deter those eligible for programs that ensure well-being from enrolling. The Stabilize Medicaid and CHIP Coverage Act of 2019 would decrease coverage disruptions for Medicaid and CHIP enrollees. The Medicaid and CHIP Payment and Access Commission (MACPAC), which was established to review both programs, has previously recommended eliminating all CHIP waiting periods and expanding the continuous 12-month eligibility option. The National Assembly supports S. 873 because continuous healthcare coverage ensures the well-being of all individuals and allows everyone to reach their full potential. Moreover, all communities benefit from increasing access to needed services.

Looking Forward

Since introduction, S. 873 was referred to the Committee on Finance. The National Assembly will continue to follow the bill closely. For more information on the Stabilize Medicaid and CHIP Coverage Act of 2019 and other healthcare legislation, check out PolicySource, the National Assembly’s comprehensive database for legislation that would impact the human services sector.