The CEOs and executive leaders of several consumer health and safety net organizations have penned a letter to U.S. Senate leaders Chuck Schumer and Mitch McConnell urging inclusion of four Medicaid and Children’s Health Insurance Program (CHIP) policies as the Senate deliberates on an end-of-year package.
The letter states that the proposed policies will ensure that individuals eligible for Medicaid and CHIP have stable and comprehensive health coverage that provides affordable access to high-quality care, ultimately improving low- and middle-income Americans' overall health and well-being.
The authors include:
• Margaret A. Murray, CEO, Association for Community Affiliated Plans
• Mark Del Monte, J.D., CEO | Executive Vice President American Academy of Pediatrics
• Mark Wietecha, CEO, Children’s Hospital Association
• Emily Stewart, Executive Director, Community Catalyst
• Frederick Isasi, Executive Director, Families USA
• Bruce Lesley, President, First Focus Campaign for Children
The authors urge the Senate to enact nationwide 12-month continuous eligibility for all children enrolled in CHIP and Medicaid. They note that children’s health is impacted when they cycle on and off of Medicaid and CHIP, a phenomenon known as “churn.” These changes in health coverage lead to gaps in critical physical and behavioral healthcare. “Especially now with the growing number of behavioral health issues among children and Respiratory Syncytial Virus (RSV) cases on the rise, it is more important than ever to prevent gaps in coverage,” the letter says.
In addition, the authors ask the Senate to provide permanent CHIP funding. CHIP provides health insurance coverage to 10 million low- and middle-income children and pregnant women who are not eligible for Medicaid. However, CHIP is the only federal health coverage program requiring periodic funding extensions. In the past, Congress has delayed funding extensions for CHIP, leading to instability and confusion among the millions of families that rely on this critical program to keep their children healthy, the letter states. “Permanently funding CHIP will prevent federal inefficiencies and provide stability and certainty for states, healthcare providers, and most importantly, families while also ensuring access to essential healthcare services to improve health and quality of life. The Congressional Budget Office (CBO) has said this measure is expected to reduce federal costs so it should have no net impact on the deficit. This should be a non-controversial ask as part of any end-of-year negotiations.”
The stakeholders urge the Senate to address the nation’s maternal mortality crisis by enacting a nationwide policy of 12 months postpartum coverage in Medicaid and CHIP.
Tens of millions of births are covered by Medicaid and CHIP. Unfortunately, compared to individuals with private insurance, Medicaid enrollees had an 82 percent higher risk of maternal death and morbidity. The authors note that the Medicaid program's expansion under the Affordable Care Act (ACA) has been linked to notable gains in maternal health outcomes, notably for non-Hispanic Black women, and within the first 60 days following childbirth when Medicaid coverage currently expires for many postpartum people. “Still, far too many people experience coverage and care gaps either during their pregnancies or in the weeks and months that follow, giving rise to health risks and exacerbating racial and ethnic disparities in maternal health. Currently, only 27 states offer 12 months of postpartum coverage. This policy was enacted as a time-limited state option in the American Rescue Plan Act, and it helps ensure that birthing people have access to quality health care during a critical — and potentially health-threatening — time in their lives.”
Finally, the authors urge the Senate to include the policies within the Medicaid Reentry Act in an end-of-year package. The “Medicaid Inmate Exclusion Policy” prohibits the use of Medicaid funds for services to otherwise eligible people who are incarcerated in jails, prisons, detention centers, or other correctional facilities. This leads to serious gaps in health coverage and access to needed care when individuals are re-entering their communities from incarceration. These gaps contribute to higher recidivism and are particularly harmful – and often deadly -- for the large percentage of formerly incarcerated individuals with mental illness or substance use disorders, the letter states. “Allowing eligible incarcerated individuals to receive services covered by Medicaid 30 days prior to their release from jail or prison will expand access to vital health services, decrease recidivism and improve health outcomes for individuals re-entering the community. Furthermore, by investing in prevention, the bipartisan Medicaid Reentry Act will provide savings on healthcare and criminal justice costs for jurisdictions across the country.”
Together, the authors conclude, these four policy changes have the potential to add stability to a frequently fragmented healthcare system and, more importantly, to improve the health and well-being of low- and middle-income individuals.
