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 Legislative and Policy Corner

CHIP and Other Expiring Programs
On Oct. 4 the Senate Finance Committee and the House Energy and Commerce Committee passed bills to extend CHIP (Children's Health Insurance Program) for another five years. The House Energy and Commerce Committee also passed the CHAMPION Act to extend for two years a number of other expiring programs, including:

  • Personal Responsibility Education Program (PREP) at $75 million a year
  • Family to Family Information Centers at $6 million a year (a $1 million/year increase) 
  • Abstinence Education Grant Program (renamed the Youth Empowerment Program) at $75 million a year
  • Community Health Centers
  • National Health Service Corps

Unfortunately, the offsets used for the CHAMPION Act included a reduction to the Prevention and Public Health Fund (PPHF) by over 50 percent. AMCHP sent this letter to the House Energy and Commerce Committee opposing reductions to the PPHF. Democrats on the House Energy and Commerce Committee opposed the offsets proposed for both the CHAMPION Act and the CHIP reauthorization bill, which means there may be a rough path ahead for passing these bills. It is possible that, although funding for these programs technically expired Sept. 30, Congress might not finalize action until it tackles the Dec. 8 deadline for the continuing resolution on appropriations. 

Administration Rolls Back Contraception Coverage Requirement
On Oct. 6 the Trump administration announced that it was broadening the exemption for the Affordable Care Act requirement that employers cover contraception in their health insurance plans, by allowing virtually any employer to avoid the requirement based on religious beliefs or moral convictions. The ACLU as well as attorneys general for at least three states have filed suits against the administration to block the change.

Impact of Halting CSR Payments
In an Oct. 12 Executive Order, the Trump administration announced it will no longer reimburse insurers for cost-sharing reductions (CSRs). CSRs were created through the Affordable Care Act to lower out-of-pocket costs for individuals with low income who have Marketplace plans. In the 2017 open enrollment period, approximately 12.2 million people enrolled or re-enrolled in a Marketplace plan and approximately 58 percent of those  individuals receive support through CSRs, according to a report from the Centers for Medicare and Medicaid Services. 

Ending CSR payments could result in higher premiums and out-of-pocket costs, which  may render plans unaffordable for families. There is also the risk of insurers pulling out of the Marketplaces due to uncertainty about CSR payments in the future. The effects of the termination could be greatly felt by low-income women and men of reproductive age and their families. However, the termination of the payments might place more pressure on Congress to directly fund these subsidies going forward.