Health Care Organizations to Senate: Include Medicaid & CHIP Policies in Reconciliation

WASHINGTON, July 26 (TNSreact) -- The Association for Community Affiliated Plans issued the following news release:

Seven national health care and advocacy organizations today called on U.S. Senate leaders to include Medicaid and Children's Health Insurance Program (CHIP) policies in Congress' much-discussed reconciliation package. Experts say the measures are urgently needed to improve access to affordable, high-quality health care coverage, benefiting the health and wellbeing of people with low incomes.

"When people with Medicaid and CHIP experience gaps in their coverage, they are less likely to get the health care they need when they need it, which negatively impacts their health," said Jennifer McGuigan Babcock, senior vice president at the Association for Community Affiliated Plans. "Amidst a pandemic, sputtering economy, and high prices, Congress must increase access to affordable, quality health care coverage for those who most need help accessing care. Now is the time to take action by including Medicaid and CHIP priorities in the reconciliation package."

The policies would allow children to keep their Medicaid and CHIP coverage for a year, regardless of temporary changes in family income and other circumstances; require a year of postpartum coverage for people on Medicaid and CHIP who give birth; make CHIP funding permanent; minimize gaps in coverage and behavioral and physical care for people leaving jails and prisons; and increase vaccination access for adults on Medicaid.

The U.S. Supreme Court's Dobbs decision makes including Medicaid and CHIP policies in the reconciliation package even more critical, experts say. Lack of access to reproductive care threatens to boost the United States' already high maternal mortality rate unless Congress acts to protect women.

"Congressional action to boost access to Medicaid and CHIP coverage is urgently needed to protect the health of women and children," said Lisa Shapiro, Senior Advisor for Strategy and Children's Policy at Families USA.

Coalition members calling for inclusion of Medicaid and CHIP policies in Senate legislation are the American Academy of Pediatrics, Association for Community Affiliated Plans, Children's Hospital Association, Community Catalyst, Families USA, First Focus Campaign for Children and National Alliance on Mental Illness.

The coalition previously hosted a hill briefing and sent a sign-on letter to Senate leadership urging inclusion of the Medicaid and CHIP package in reconciliation.

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July 14, 2022

To: The Honorable Charles Schumer, Majority Leader, United States Senate, Washington, D.C. 20510

The Honorable Richard Durbin, Majority Whip, United States Senate, Washington, D.C. 20510

The Honorable Patty Murray, Assistant Democratic Leader, United States Senate, Washington, D.C. 20510

The Honorable Debbie Stabenow, Democratic Policy Committee Chair, United States Senate, Washington, D.C. 20510

Dear Majority Leader Schumer, Majority Whip Durbin, Assistant Leader Murray, and DPC Chair Stabenow,

We, the undersigned organizations, urge the inclusion of the following five Medicaid and CHIP policies as the Senate deliberates on a reconciliation package this summer. These policies will ensure that individuals enrolled in Medicaid and CHIP have comprehensive health coverage that provides affordable access to high-quality care, ultimately improving low-income Americans' overall health and well-being.

1. Medicaid and CHIP Continuous Eligibility for Children. We ask that you consider the detrimental impact on children's health 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 health care. Providing continuous eligibility for children would help mitigate this by allowing young people to remain enrolled in Medicaid and CHIP for 12 months, regardless of changes in family income or other circumstances. Currently, fewer than 30 states have adopted the state option by offering 12-month continuous eligibility to all children enrolled in CHIP and/or Medicaid. If every state were to implement this bipartisan policy, it would make a dramatic difference in the lives of millions of children and families.

2. Medicaid and CHIP Postpartum Coverage. Nearly half of all births in the US are covered by Medicaid. Unfortunately, compared to those with private insurance, Medicaid enrollees had an 82 percent higher risk of maternal death and morbidity. 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 this coverage. Considering the crisis our nation is presently facing relative to maternal health issues, we urge the Senate to require 12 months of postpartum coverage for all birthing people on Medicaid and CHIP. This policy was enacted as a time-limited state option in the American Rescue Plan Act and is supported by the Biden-Harris Administration/1 . It helps ensure that birthing people have access to quality health care during a critical - and potentially health-threatening - time in their lives. 3. Permanent CHIP Funding. The Children's Health Insurance Program (CHIP) provides health insurance coverage to 10 million low- and middle-income children and pregnant women who are not eligible for Medicaid. CHIP is a vital program that helps to ensure that children have access to quality care while also reducing the number of uninsured children in the United States. CHIP is the only federal health coverage program that is temporary and comes up for repeated 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. Providing permanent CHIP funding will provide stability and certainty for states and families while also ensuring access to essential health care services to improve their health and quality of life.

4. Medicaid Reentry Act. 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 reentering 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. 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 reentering the community. Furthermore, by investing in prevention, the bipartisan Medicaid Reentry Act/2 will provide savings on healthcare and criminal justice costs for jurisdictions across the country.

5. Adult Vaccination Access. Adults need immunizations to protect them from getting and spreading serious infectious diseases that result in disability, missed work, medical bills, inability to care for family members, hospitalization, or death. For low-income individuals, Medicaid is the primary source of coverage for vaccines. Medicaid coverage and reimbursement policies vary greatly by state, creating barriers to access that impede efforts to improve vaccination rates among at-risk populations who are low-income. In states that have expanded Medicaid, programs are required to cover recommended vaccines at no cost, which is consistent with commercial health insurance coverage standards, in non-expansion states, people with traditional Medicaid coverage have to pay for the same recommended vaccines. Only 22 Medicaid programs cover all 13 Advisory Committee on Immunization Practices (ACIP) recommended adult immunizations while 14 states allow cost-sharing. When Americans have to pay for vaccines, they are less likely to be vaccinated. This doesn't just harm the individual but can negatively impact the entire community. The Helping Adults Protect Immunity Act would create parity in vaccine coverage between traditional Medicaid and Medicaid expansion programs and improve access to this important preventative service.

Our coalition urges the Senate to include these critical Medicaid and CHIP policies in the reconciliation package currently under development. A post-Roe world threatens to send our already-high maternal mortality rate higher still. Congress should start by shoring up the safety net to assure access to care for our mothers and newborns. Each of these policies has the potential to improve the health and well-being of low-income Americans, especially mothers and newborns, and we urge you to keep the millions of people served by Medicaid and CHIP in mind as you deliberate what goes into the final package.

We thank you for your attention and leadership on these important measures. We look forward to working with you and the Senate in making these policies a reality.

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Sincerely,

National Organizations

Adult Vaccine Access Coalition

American Academy of Pediatrics

Association for Community Affiliated Plans

Children's Hospital Association

Community Catalyst

Families USA

First Focus Campaign for Children

National Alliance on Mental Illness