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March 2014 Report to the Congress on Medicaid and CHIP

The roles of Medicaid and State Children’s Health Insurance Program (CHIP) are changing. Medicaid has expanded, with about half the states covering a new group of low-income adults as of January 1, 2014. The Patient Protection and Affordable Care Act (ACA, P.L. 111-148, as amended) created new health insurance exchanges that interact with both Medicaid and CHIP. With CHIP funding scheduled to run out after fiscal year 2015, policymakers also have a new opportunity to consider a long-term vision for children’s health coverage.

In this March report, we explore six specific issues raised by the changing roles of Medicaid and CHIP: Medicaid and CHIP in the context of the ACA; continuity of coverage for adults under age 65; pregnancy coverage in Medicaid and exchange plans; program integrity issues raised by ACA eligibility changes; children’s coverage under CHIP and exchange plans, and policy implications of Medicaid non-disproportionate share hospital supplemental payments.