The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) Feb. 26-27 met to discuss the short and long-term options for children’s health care coverage, behavioral health related care, and future policy considerations for shared savings in Medicaid.
Without congressional action, federal support for CHIP expires at the end of fiscal year (FY) 2015. The commissioners reaffirmed their recommendation from the June 2014 Report to Congress to extend federal funding for CHIP for a transition period of two years and agreed to send a letter to Congress emphasizing the importance of extending CHIP funding immediately in a manner that reduces administrative, state, and family burdens.
The commissioners also discussed long-term issues to improve exchange coverage for children, including: the family glitch, affordability of exchange plan premiums for children, affordability of exchange plan cost sharing for children, pediatric dental benefits for children with exchange coverage, and benefits for children with exchange coverage.
The first day concluded with a staff presentation on issues related to Medicaid behavioral health enrollees. Approximately 13 million enrollees, almost a fifth of the Medicaid population, have a behavioral health related diagnosis. Approximately $170 billion total is spent on these enrollees, accounting for half of all Medicaid expenditures. The commission plans to delve further into the types of services this group is utilizing, identify which interventions have been successful, and break down behavioral health related costs for subgroups within Medicaid.
The second day included a joint presentation by Mark McClellan, M.D., Ph.D., senior fellow, Brookings Institution, and Alan Weil, editor-in-chief, Health Affairs, to discuss various shared savings opportunities under Medicaid. The presentation followed their 2013 Health Affairs articles “Moving Forward On Medicaid Reform: Shared Savings In Medicaid, And How To Do It” and “Promoting Cooperative Federalism Through State Shared Savings.” The presenters advocated for a more standardized Medicaid program that moves away from a system of waivers, with additional focus on national cost and quality outcome metrics.