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A Tale of Two Bills

It’s been more than a month since Congress missed the September 30 deadline to fund the Children’s Health Insurance Program (CHIP), leaving health coverage for 75,000 children and pregnant women in Colorado hanging in the balance.

Now the clock is ticking as states spend down their CHIP savings.

Colorado officials are being very careful in their communications so that enrollees in the Colorado program — called Child Health Plan Plus (CHP+) — don’t mistakenly think it has already ended. But a letter has been posted online saying that without a funding reauthorization in the next week, by November 18, the state’s program will end on January 31.

At the same time, Colorado officials have been working closely with Connect for Health Colorado, the state’s health insurance marketplace, where CHP+ families may turn to obtain coverage if the CHP+ funding goes away.

Two bills have been introduced to reauthorize the funding — one in the House and the other in the Senate. Here’s what you need to know:

Senators Orrin Hatch (R-Utah) and Ron Wyden (D-Oregon) introduced legislation in September to extend CHIP funding through 2022. Their bill keeps the funding for CHIP, but decreases the amount the federal government pays for the program.

This amount — called the federal medical assistance percent or FMAP — is 88 percent for Colorado. The proposed legislation decreases it to 65 percent by 2021. The bill passed the Senate Finance Committee on October 4 but there is little language about how Congress will pay for the program beyond reducing the federal share.

Colorado’s senators, Democrat Michael Bennet and Republican Cory Gardner, both lauded the bipartisan legislation. Senator Gardner said he and Senator Bennet will work with colleagues on both sides of the aisle to help pass it.

A bill introduced in the House by Representative Greg Walden (R-Oregon), extends funding until 2022 and includes funding for other items such as community health centers, diabetes programs and youth empowerment programs.

The legislation would offset the cost of continuing the CHIP funding in a variety of ways. These include cutting existing prevention and public health funding, increasing Medicare premiums for seniors who make over $500,000 a year, and shortening the grace period for people who don’t pay premiums on time for coverage they purchased through the Affordable Care Act (ACA) marketplaces.

The bill reduces the FMAP from 88 percent in Colorado to 65 percent by 2021. It passed out of the House on November 3 and now heads to the Senate.

Colorado’s Congressional delegation was split along party lines: Republicans Scott Tipton, Ken Buck, Doug Lamborn and Mike Coffman voted in favor of the legislation while Democrats Diana DeGette, Jared Polis and Ed Perlmutter opposed the bill.

Meantime, states are developing contingency plans in case Congress fails to pass legislation by the end of the year. In Colorado, the Department of Health Care Policy and Financing (HCPF), which oversees the Medicaid and CHP+ programs, said in a letter posted on its website that although there are no changes to coverage right now, the Colorado program will end on January 31 without reauthorization of funding.

The letter is scheduled to be sent to CHP+ enrollees beginning November 27 if Congress doesn’t act by November 18. It will include information on how to contact Connect for Health Colorado, which is making plans to help CHP+ families understand their options and sign up for coverage.

CHP+, which is available to families with incomes a bit higher than the cut-off for Medicaid, charges a small annual premium plus some out-of-pocket costs. Transferring to the individual market through Connect for Health Colorado could mean that Colorado families will find themselves paying more for health care coverage and out-of-pocket costs for medical care.

Still, many CHP+ families will qualify for financial assistance in the form of tax credits to lower the price of their premiums and cost sharing reductions to help with out-of-pocket costs.

Both the House and Senate bills would keep all 75,000 children and pregnant women in Colorado covered if they pass. Not passing legislation leaves Colorado families in limbo.

The CHP+ program has contributed to Colorado’s historically low uninsured rate of three percent among Colorado children under the age of 19. Not continuing funding for CHP+ will likely increase the uninsured rate among Colorado’s children and pregnant women.

CHI’s issue brief Kids, Congress and Colorado: The Future of CHP+ found that CHP+ coverage is particularly important in rural parts of the state. CHI will continue to monitor developments in the CHIP funding saga over these next crucial weeks.It’s been more than a month since Congress missed the September 30 deadline to fund the Children’s Health Insurance Program (CHIP), leaving health coverage for 75,000 children and pregnant women in Colorado hanging in the balance.

Now the clock is ticking as states spend down their CHIP savings.

Colorado officials are being very careful in their communications so that enrollees in the Colorado program — called Child Health Plan Plus (CHP+) — don’t mistakenly think it has already ended. But a letter has been posted online saying that without a funding reauthorization in the next week, by November 18, the state’s program will end on January 31.

At the same time, Colorado officials have been working closely with Connect for Health Colorado, the state’s health insurance marketplace, where CHP+ families may turn to obtain coverage if the CHP+ funding goes away.

Two bills have been introduced to reauthorize the funding — one in the House and the other in the Senate. Here’s what you need to know:

Senators Orrin Hatch (R-Utah) and Ron Wyden (D-Oregon) introduced legislation in September to extend CHIP funding through 2022. Their bill keeps the funding for CHIP, but decreases the amount the federal government pays for the program.

This amount — called the federal medical assistance percent or FMAP — is 88 percent for Colorado. The proposed legislation decreases it to 65 percent by 2021. The bill passed the Senate Finance Committee on October 4 but there is little language about how Congress will pay for the program beyond reducing the federal share.

Colorado’s senators, Democrat Michael Bennet and Republican Cory Gardner, both lauded the bipartisan legislation. Senator Gardner said he and Senator Bennet will work with colleagues on both sides of the aisle to help pass it.

A bill introduced in the House by Representative Greg Walden (R-Oregon), extends funding until 2022 and includes funding for other items such as community health centers, diabetes programs and youth empowerment programs.

The legislation would offset the cost of continuing the CHIP funding in a variety of ways. These include cutting existing prevention and public health funding, increasing Medicare premiums for seniors who make over $500,000 a year, and shortening the grace period for people who don’t pay premiums on time for coverage they purchased through the Affordable Care Act (ACA) marketplaces.

The bill reduces the FMAP from 88 percent in Colorado to 65 percent by 2021. It passed out of the House on November 3 and now heads to the Senate.

Colorado’s Congressional delegation was split along party lines: Republicans Scott Tipton, Ken Buck, Doug Lamborn and Mike Coffman voted in favor of the legislation while Democrats Diana DeGette, Jared Polis and Ed Perlmutter opposed the bill.

Meantime, states are developing contingency plans in case Congress fails to pass legislation by the end of the year. In Colorado, the Department of Health Care Policy and Financing (HCPF), which oversees the Medicaid and CHP+ programs, said in a letter posted on its website that although there are no changes to coverage right now, the Colorado program will end on January 31 without reauthorization of funding.

The letter is scheduled to be sent to CHP+ enrollees beginning November 27 if Congress doesn’t act by November 18. It will include information on how to contact Connect for Health Colorado, which is making plans to help CHP+ families understand their options and sign up for coverage.

CHP+, which is available to families with incomes a bit higher than the cut-off for Medicaid, charges a small annual premium plus some out-of-pocket costs. Transferring to the individual market through Connect for Health Colorado could mean that Colorado families will find themselves paying more for health care coverage and out-of-pocket costs for medical care.

Still, many CHP+ families will qualify for financial assistance in the form of tax credits to lower the price of their premiums and cost sharing reductions to help with out-of-pocket costs.

Both the House and Senate bills would keep all 75,000 children and pregnant women in Colorado covered if they pass. Not passing legislation leaves Colorado families in limbo.

The CHP+ program has contributed to Colorado’s historically low uninsured rate of three percent among Colorado children under the age of 19. Not continuing funding for CHP+ will likely increase the uninsured rate among Colorado’s children and pregnant women.

CHI’s issue brief Kids, Congress and Colorado: The Future of CHP+ found that CHP+ coverage is particularly important in rural parts of the state. CHI will continue to monitor developments in the CHIP funding saga over these next crucial weeks.