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Children's Health Advocates Watch for Overdue Marketplace Analysis

By Marissa Evans, CQ Roll Call

August 14, 2015 -- Funding for the Children's Health Insurance Program (CHIP) expires in two years, and most health policy experts say that private insurance plans in the new health care law marketplaces don't come close to offering comparable benefits for children. The Department of Health and Human Services (HHS), which oversees the marketplace plans, was supposed to compare the coverage in a report that was due April 1.

The overdue analysis is likely to significantly influence the debate over whether the states' CHIP coverage should continue beyond 2017. More than 8 million children could be affected.

The report could put the administration in the politically awkward position of finding that coverage in the health care law marketplaces—which  President Barack Obama made a centerpiece of his domestic policy agenda—offers insurance that is not as beneficial for children currently receiving CHIP coverage.

HHS officials declined to explain the delay.

"At this time, we do not have an update on the report," according to an email statement from an HHS official.

CHIP was implemented in 1997 to provide health coverage to children in families earning between 200 percent and 300 percent of the federal poverty level—too much money to qualify for Medicaid but typically not enough to afford private insurance plans. Before the Affordable Care Act, Medicaid typically covered families making up to 100 percent of the federal poverty line. In 2013, 8.1 million kids were covered under CHIP at a cost of $13 billion.

Congress reauthorized funding for the program until 2017 but the report was supposed to give some indication on where insurance coverage for kids stands now.
Lawmakers criticized the delay.

"Sen. Alexander is disappointed that the administration has failed to meet the explicit requirement established in the President's health care law and release this study—now more than 4 months overdue—so that Americans will know how plans on the Obamacare exchange are serving our children who need help the most," according to an aide for Alexander in an email statement.

Even though funding expires in 2017, children's advocates and CHIP program directors are already working to find solutions to make sure the plans in the exchange would be comparable for CHIP beneficiaries.

Trish Riley, executive director for the National Academy for State Health Policy said that policymakers should not wait for the report to explore solutions aimed at ensuring that private commercial insurance plans are as extensive as CHIP and Medicaid plans for pediatric coverage. The group is planning to convene a study group of policy analysts this fall to tackle the issue.

"The bigger question is less about this report then how do we take lessons of CHIP and make commercial policies work," Riley said.

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