Hudson Julie L, Hill Steven C, Selden Thomas M
Julie L. Hudson (
Steven C. Hill is a senior economist in the Division of Modeling and Simulation, Center for Financing, Access, and Cost Trends, AHRQ.
Health Aff (Millwood). 2015 May;34(5):864-70. doi: 10.1377/hlthaff.2015.0004.
In spring 2015 Congress passed legislation to extend funding for the Children's Health Insurance Program (CHIP) through the end of fiscal year 2017. This two-year extension pushes to 2017 the question of whether CHIP funding will end, allowing states to end their separate state CHIP programs. Also, when the Affordable Care Act's maintenance-of-effort requirements expire after 2019, states will be allowed to roll back Medicaid- and CHIP-eligibility thresholds to minimum levels allowed by federal law. This study investigated the potential health insurance options available to low-income children if these events happen. If all states roll back coverage to federal statutory minimums, then, among children in families with incomes up to 400 percent of the federal poverty guidelines, the share ineligible for public coverage or subsidized Marketplace coverage would increase from 22 percent in 2014 (12.5 million children) to 46 percent after 2019 (26.5 million children). While not all states are likely to reduce eligibility to federal statutory minimums, these estimates highlight the fact that many children who do lose public eligibility will not become eligible for subsidized Marketplace coverage.
2015年春季，国会通过立法，将儿童健康保险计划（CHIP）的资金延长至2017财年年底。这一为期两年的延期将CHIP资金是否会终止的问题推迟到了2017年，使得各州得以终止各自的州CHIP计划。此外，当《平价医疗法案》的保持努力要求在2019年后到期时，各州将被允许把医疗补助和CHIP的资格门槛降至联邦法律允许的最低水平。本研究调查了如果这些情况发生，低收入儿童可获得的潜在医疗保险选项。如果所有州都将保险覆盖范围降至联邦法定最低水平，那么在收入高达联邦贫困指导标准400%的家庭中的儿童中，无资格获得公共保险或补贴性市场保险的比例将从2014年的22%（1250万儿童）增至2019年后的46%（2650万儿童）。虽然并非所有州都可能将资格降低到联邦法定最低水平，但这些估计凸显了这样一个事实，即许多失去公共资格的儿童将无资格获得补贴性市场保险。
