{ "id": "R43949", "type": "CRS Report", "typeId": "REPORTS", "number": "R43949", "active": true, "source": "EveryCRSReport.com", "versions": [ { "source": "EveryCRSReport.com", "id": 581405, "date": "2018-05-23", "retrieved": "2018-05-24T22:04:42.093789", "title": "Federal Financing for the State Children\u2019s Health Insurance Program (CHIP)", "summary": "The State Children\u2019s Health Insurance Program (CHIP) is a means-tested program that provides health coverage to targeted low-income children and pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance. CHIP is jointly financed by the federal government and the states, and the states are responsible for administering CHIP. \nThe federal government\u2019s share of CHIP expenditures (including both services and administration) is determined by the enhanced federal medical assistance percentage (E-FMAP) rate. The E-FMAP varies by state; statutorily, the E-FMAP can range from 65% to 85%. The E-FMAP is increased by 23 percentage points for FY2016 through FY2019 and by 11.5 percentage points for FY2020. In FY2021, the E-FMAP is to return to the regular E-FMAP rates. \nThe federal appropriation for CHIP is provided in statute. From this federal appropriation, states receive CHIP allotments, which are the federal funds allocated to each state and the territories for the federal share of their CHIP expenditures. In addition, if a state has a shortfall in federal CHIP funding, there are a few sources of shortfall funding, such as the Child Enrollment Contingency Fund, redistribution funds, and Medicaid funds.\nFY2018 began on October 1, 2017, without federal CHIP funding having been appropriated for the fiscal year. The full-year FY2018 appropriation for CHIP was not provided until January 22, 2018, when CHIP was provided appropriations for FY2018 through FY2023 through the continuing resolution enacted on January 22, 2018 (P.L. 115-120). Then, on February 9, 2018, the Bipartisan Budget Act of 2018 (BBA 2018; P.L. 115-123) provided CHIP appropriations for FY2024 through FY2027. \nThis report provides an overview of CHIP financing, beginning with an explanation of the federal matching rate. It describes various aspects of federal CHIP funding, such as the federal appropriation, state allotments, the Child Enrollment Contingency Fund, redistribution funds, and outreach and enrollment grants. The report ends with a section about the recent legislative activity that has resulted in federal funding for CHIP being provided through FY2027.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R43949", "sha1": "4f2611569f8c6f985793e309d84a19fdf8ba6680", "filename": "files/20180523_R43949_4f2611569f8c6f985793e309d84a19fdf8ba6680.html", "images": { "/products/Getimages/?directory=R/html/R43949_files&id=/1.png": "files/20180523_R43949_images_c146dd76220f4c714f71882e7cafbc1bff242511.png", "/products/Getimages/?directory=R/html/R43949_files&id=/2.png": "files/20180523_R43949_images_ce11b56dd896c470931634b76d80c3d0405fd57f.png", "/products/Getimages/?directory=R/html/R43949_files&id=/0.png": "files/20180523_R43949_images_3116bde6fd14bca7b217b1ac4339bb3c9294742c.png", "/products/Getimages/?directory=R/html/R43949_files&id=/3.png": "files/20180523_R43949_images_b6082d9b9aad34a6e039cfad7b4cb097d328c87e.png" } }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R43949", "sha1": "687ef7178860082e9964baff553628ee28c0b8d8", "filename": "files/20180523_R43949_687ef7178860082e9964baff553628ee28c0b8d8.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" } ] }, { "source": "EveryCRSReport.com", "id": 577686, "date": "2018-01-17", "retrieved": "2018-05-10T11:43:07.228217", "title": "Federal Financing for the State Children\u2019s Health Insurance Program (CHIP)", "summary": "The State Children\u2019s Health Insurance Program (CHIP) is a means-tested program that provides health coverage to targeted low-income children and pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance. CHIP is jointly financed by the federal government and the states, and the states are responsible for administering CHIP. \nThe federal government\u2019s share of CHIP expenditures (including both services and administration) is determined by the enhanced federal medical assistance percentage (E-FMAP) rate. Statutorily, the E-FMAP can range from 65% to 85%. The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) included a provision to increase the E-FMAP rate by 23 percentage points for most CHIP expenditures from FY2016 through FY2019. With this increase, the E-FMAP ranges from 88% to 100%.\nThe federal appropriation for CHIP is provided in statute. From this federal appropriation, states receive CHIP allotments, which are the federal funds allocated to each state and the territories for the federal share of their CHIP expenditures. In addition, if a state has a shortfall in federal CHIP funding, there are a few sources of shortfall funding, such as the Child Enrollment Contingency Fund, redistribution funds, and Medicaid funds.\nIn statute, FY2017 was the last year a full-year federal CHIP appropriation was provided, so a law would need to be enacted if federal funding of CHIP were to be continued. Even though federal CHIP funding has expired, states have federal CHIP spending in FY2018 because states have access to unspent funds from their FY2017 allotments and to unspent allotments from FY2016 and prior years redistributed to shortfall states. In addition, the continuing resolutions enacted on December 8, 2017, and December 22, 2017, both include provisions that provide short-term funding for CHIP. The continuing resolution enacted on December 8, 2017, included a special rule for redistribution funds to prioritize the allocation of funds to states estimated to exhaust federal CHIP funds before January 1, 2018. The continuing resolution enacted on December 22, 2017, includes short-term appropriations and an extension of the special rule for redistribution funds through March 2018.\nUnder current law, the ACA maintenance of effort (MOE) requirement for children is in place through FY2019. The MOE provision requires states to maintain income eligibility levels for CHIP children through September 30, 2019, as a condition for receiving federal Medicaid payments (notwithstanding the lack of corresponding full-year federal CHIP appropriations for FY2018 and FY2019). If additional federal CHIP funding is not provided, the MOE requirement would affect CHIP Medicaid expansion programs and separate CHIP programs differently. States with CHIP Medicaid expansion programs must continue to cover their CHIP children once federal funding is no longer available. However, states with separate CHIP programs would not be required to continue coverage after enrolling eligible children in Medicaid or certified qualified health plans. \nCongress\u2019s action or inaction will determine the future of CHIP and of health coverage for CHIP children. In considering the future of CHIP, Congress has a number of policy options, including extending federal CHIP funding and continuing the program, or letting CHIP funding expire.\nThis report provides an overview of CHIP financing, beginning with an explanation of the federal matching rate. It describes various aspects of federal CHIP funding, such as the federal appropriation, state allotments, the Child Enrollment Contingency Fund, redistribution funds, and outreach and enrollment grants. The report ends with a section about the future of CHIP funding, including the options for extending CHIP funding and what could happen if federal funding expires.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R43949", "sha1": "31ea585e8f26de44b3fb379832b933983604c999", "filename": "files/20180117_R43949_31ea585e8f26de44b3fb379832b933983604c999.html", "images": { "/products/Getimages/?directory=R/html/R43949_files&id=/1.png": "files/20180117_R43949_images_c146dd76220f4c714f71882e7cafbc1bff242511.png", "/products/Getimages/?directory=R/html/R43949_files&id=/2.png": "files/20180117_R43949_images_ce11b56dd896c470931634b76d80c3d0405fd57f.png", "/products/Getimages/?directory=R/html/R43949_files&id=/3.png": "files/20180117_R43949_images_117f5d71a37980ae71b54b025e74075024d7c24d.png", "/products/Getimages/?directory=R/html/R43949_files&id=/0.png": "files/20180117_R43949_images_3116bde6fd14bca7b217b1ac4339bb3c9294742c.png" } }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R43949", "sha1": "77ce17a1eab1b9d5edc7c4ce39ad10aeff4121ab", "filename": "files/20180117_R43949_77ce17a1eab1b9d5edc7c4ce39ad10aeff4121ab.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" } ] }, { "source": "EveryCRSReport.com", "id": 573895, "date": "2017-09-29", "retrieved": "2017-10-10T17:13:22.736538", "title": "Federal Financing for the State Children\u2019s Health Insurance Program (CHIP)", "summary": "The State Children\u2019s Health Insurance Program (CHIP) is a means-tested program that provides health coverage to targeted low-income children and pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance. CHIP is jointly financed by the federal government and the states, and the states are responsible for administering CHIP. \nThe federal government\u2019s share of CHIP expenditures (including both services and administration) is determined by the enhanced federal medical assistance percentage (E-FMAP) rate. Statutorily, the E-FMAP can range from 65% to 85%. The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) included a provision to increase the E-FMAP rate by 23 percentage points for most CHIP expenditures from FY2016 through FY2019. With this increase, the E-FMAP ranges from 88% to 100%.\nThe federal appropriation for CHIP is provided in statute. From this federal appropriation, states receive CHIP allotments, which are the federal funds allocated to each state and the territories for the federal share of their CHIP expenditures. In addition, if a state has a shortfall in federal CHIP funding, there are a few sources of shortfall funding, such as the Child Enrollment Contingency Fund, redistribution funds, and Medicaid funds.\nIn statute, FY2017 is the last year a federal CHIP appropriation is provided, so a law would need to be enacted if federal funding of CHIP is to be continued. Even though federal CHIP funding is set to expire after FY2017, states are expected to have federal CHIP spending in FY2018 because states will have access to unspent funds from their FY2017 allotments and to unspent FY2016 allotments redistributed to shortfall states (if any). According to an estimate conducted by the Medicaid and CHIP Payment and Access Commission, without additional federal CHIP funding, three states (Arizona, Minnesota, and North Carolina) and the District of Columbia are projected to exhaust their federal CHIP funding by the end of the first fiscal quarter of FY2018, and more than half of states are projected to exhaust their federal CHIP funding by the second fiscal quarter.\nUnder current law, the ACA maintenance of effort (MOE) requirement for children is in place through FY2019. The MOE provision requires states to maintain income eligibility levels for CHIP children through September 30, 2019, as a condition for receiving federal Medicaid payments (notwithstanding the lack of corresponding federal CHIP appropriations for FY2018 and FY2019). If federal CHIP funding expires, the MOE requirement would affect CHIP Medicaid expansion programs and separate CHIP programs differently. States with CHIP Medicaid expansion programs must continue to cover their CHIP children once federal funding is no longer available. However, states with separate CHIP programs would not be required to continue coverage after enrolling eligible children in Medicaid or certified qualified health plans. \nWith FY2017 being the final year for which federal CHIP funding is provided in statute, Congress\u2019s action or inaction will determine the future of CHIP and of health coverage for CHIP children. In considering the future of CHIP, Congress has a number of policy options, including extending federal CHIP funding and continuing the program, or letting CHIP funding expire.\nThis report provides an overview of CHIP financing, beginning with an explanation of the federal matching rate. It describes various aspects of federal CHIP funding, such as the federal appropriation, state allotments, the Child Enrollment Contingency Fund, redistribution funds, and outreach and enrollment grants. The report ends with a section about the future of CHIP funding, including the options for extending CHIP funding and what could happen if federal funding expires.\nCHIP funding was not extended before the beginning of FY2018. On October 4, 2017, both the Senate Finance Committee and the House Energy and Commerce Committee had markups on different bills that would extend CHIP federal funding through FY2022, among other provisions.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R43949", "sha1": "7a74eeeb8aabe9372406cdbfbd524f3b5e0428cb", "filename": "files/20170929_R43949_7a74eeeb8aabe9372406cdbfbd524f3b5e0428cb.html", "images": { "/products/Getimages/?directory=R/html/R43949_files&id=/1.png": "files/20170929_R43949_images_c146dd76220f4c714f71882e7cafbc1bff242511.png", "/products/Getimages/?directory=R/html/R43949_files&id=/0.png": "files/20170929_R43949_images_dc20afb993f597ce8386c04098bea4fb677ad951.png", "/products/Getimages/?directory=R/html/R43949_files&id=/4.png": "files/20170929_R43949_images_62694c4607b0c462ebb2a6c216519e59716199c0.png", "/products/Getimages/?directory=R/html/R43949_files&id=/3.png": "files/20170929_R43949_images_7c711afa91d5f3f33e0e050e852ddbaa55b8ee91.png", "/products/Getimages/?directory=R/html/R43949_files&id=/2.png": "files/20170929_R43949_images_ce11b56dd896c470931634b76d80c3d0405fd57f.png" } }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R43949", "sha1": "32d732654ca30dd13ff2ac9cdb00ee54a3e2d7f7", "filename": "files/20170929_R43949_32d732654ca30dd13ff2ac9cdb00ee54a3e2d7f7.pdf", "images": {} } ], "topics": [ { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" } ] }, { "source": "EveryCRSReport.com", "id": 455910, "date": "2016-09-19", "retrieved": "2016-10-17T19:26:50.808169", "title": "Federal Financing for the State Children\u2019s Health Insurance Program (CHIP)", "summary": "The State Children\u2019s Health Insurance Program (CHIP) is a means-tested program that provides health coverage to targeted low-income children and pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance. CHIP is jointly financed by the federal government and the states, and the states are responsible for administering CHIP. \nThe federal government\u2019s share of CHIP expenditures (including both services and administration) is determined by the enhanced federal medical assistance percentage (E-FMAP) rate. Statutorily, the E-FMAP can range from 65% to 85%. The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) included a provision to increase the E-FMAP rate by 23 percentage points for most CHIP expenditures from FY2016 through FY2019. With this increase, the E-FMAP ranges from 88% to 100%.\nThe federal appropriation for CHIP is provided in statute. From this federal appropriation, states receive CHIP allotments, which are the federal funds allocated to each state and the territories for the federal share of their CHIP expenditures. In addition, if a state has a shortfall in federal CHIP funding, there are a few sources of shortfall funding, such as the Child Enrollment Contingency Fund, redistribution funds, and Medicaid funds.\nFY2015 was the final year for which federal CHIP funding was provided in statute until the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA; P.L. 114-10) extended federal CHIP funding, among other provisions. Specifically, MACRA extended CHIP funding for two additional years (i.e., through FY2017) and maintained the current allotment formula with the 23 percentage point increase to the E-FMAP. The law also extended the qualifying state option, the Child Enrollment Contingency Fund, and outreach and enrollment grants.\nWith FY2017 now being the final year for which federal CHIP funding is provided in statute, Congress\u2019s action or inaction over the next year or so will determine the future of CHIP and of health coverage for CHIP children. In considering the future of CHIP, Congress has a number of policy options, including extending federal CHIP funding and continuing the program or letting CHIP funding expire.\nEven though federal CHIP funding is set to expire after FY2017, under current law the ACA maintenance of effort (MOE) requirement for children is in place through FY2019. The MOE provision requires states to maintain income eligibility levels for CHIP children through September 30, 2019, as a condition for receiving federal Medicaid payments (notwithstanding the lack of corresponding federal CHIP appropriations for FY2018 and FY2019). If federal CHIP funding expires, the MOE requirement would impact CHIP Medicaid expansion programs and separate CHIP programs differently. States with CHIP Medicaid expansion programs must continue to cover their CHIP children once federal funding is no longer available. However, states with separate CHIP programs would not be required to continue coverage.\nThis report provides an overview of CHIP financing, beginning with an explanation of the federal matching rate. It describes various aspects of federal CHIP funding, such as the federal appropriation, state allotments, the Child Enrollment Contingency Fund, redistribution funds, and outreach and enrollment grants. The report ends with a section about the future of CHIP funding, including the options for extending CHIP funding and what could happen if federal funding expires.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R43949", "sha1": "a091e4754bf0933a702da2425a9e280a98a9c8f9", "filename": "files/20160919_R43949_a091e4754bf0933a702da2425a9e280a98a9c8f9.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R43949", "sha1": "4c4950133e4a971e7f91ce6687772a3b48743e5b", "filename": "files/20160919_R43949_4c4950133e4a971e7f91ce6687772a3b48743e5b.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 4819, "name": "Medicaid & CHIP" } ] }, { "source": "EveryCRSReport.com", "id": 442428, "date": "2015-04-23", "retrieved": "2016-04-06T19:10:19.303713", "title": "Federal Financing for the State Children\u2019s Health Insurance Program (CHIP)", "summary": "The State Children\u2019s Health Insurance Program (CHIP) is a means-tested program that provides health coverage to targeted low-income children and pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance. CHIP is jointly financed by the federal government and the states, and the states are responsible for administering CHIP. \nThe federal government pays about 70% of CHIP expenditures, and the federal government\u2019s share of CHIP expenditures (including both services and administration) is determined by the enhanced federal medical assistance percentage (E-FMAP) rate. In FY2015, the E-FMAP rate ranges from 65% (13 states) to 82% (Mississippi). The Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) included a provision to increase the E-FMAP rate by 23 percentage points for most CHIP expenditures from FY2016 through FY2019.\nThe federal appropriation for CHIP is provided in statute. From this federal appropriation, states receive CHIP allotments, which are the federal funds allocated to each state and the territories for the federal share of their CHIP expenditures. In addition, if a state has a shortfall in federal CHIP funding, there are a few sources of shortfall funding, such as the Child Enrollment Contingency Fund, redistribution funds, and Medicaid funds.\nFY2015 was the final year for which federal CHIP funding was provided in statute, but the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA; P.L. 114-10) extended federal CHIP funding, among other provisions. Specifically, P.L. 114-10 extended CHIP funding for two additional years (i.e., through FY2017) and maintained the current allotment formula with the 23 percentage point increase to the E-FMAP. The bill also extended the qualifying state option, the Child Enrollment Contingency Fund, and outreach and enrollment grants.\nWith FY2017 now being the final year for which federal CHIP funding is provided in statute, Congress\u2019s action or inaction over the next couple of years will determine the future of CHIP and of health coverage for CHIP children. In considering the future of CHIP, Congress has a number of policy options, including extending federal CHIP funding and continuing the program or letting CHIP funding expire.\nEven though federal CHIP funding is set to expire after FY2017, under current law the ACA maintenance of effort (MOE) requirement for children is in place through FY2019. The MOE provision requires states to maintain income eligibility levels for CHIP children through September 30, 2019, as a condition for receiving federal Medicaid payments (notwithstanding the lack of corresponding federal CHIP appropriations for FY2018 and FY2019). If federal CHIP funding expires, the MOE requirement would impact CHIP Medicaid expansion programs and separate CHIP programs differently. States with CHIP Medicaid expansion programs must continue to cover their CHIP children once federal funding is no longer available. However, states with separate CHIP programs would not be required to continue coverage.\nThis report provides an overview of CHIP financing, beginning with an explanation of the federal matching rate. It describes various aspects of federal CHIP funding, such as the federal appropriation, state allotments, the Child Enrollment Contingency Fund, redistribution funds, outreach and enrollment grants, and performance bonus payments. The report ends with a section about the future of CHIP funding, including the options for extending CHIP funding and what could happen if federal funding expires.", "type": "CRS Report", "typeId": "REPORTS", "active": true, "formats": [ { "format": "HTML", "encoding": "utf-8", "url": "http://www.crs.gov/Reports/R43949", "sha1": "3540e68f18ae8144a28449c3917748a3a698853a", "filename": "files/20150423_R43949_3540e68f18ae8144a28449c3917748a3a698853a.html", "images": null }, { "format": "PDF", "encoding": null, "url": "http://www.crs.gov/Reports/pdf/R43949", "sha1": "22619e23dce01700654a0fa3a5de7fd3b20f3ae3", "filename": "files/20150423_R43949_22619e23dce01700654a0fa3a5de7fd3b20f3ae3.pdf", "images": null } ], "topics": [ { "source": "IBCList", "id": 594, "name": "Medicaid and CHIP" } ] } ], "topics": [ "Appropriations", "Health Policy" ] }