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Future of Children’s Health Insurance Program (CHIP) in Alaska

CHIP coverage extended further through September 30, 2027

February 2018 – Early this morning, Congress passed the ACCESS Act (Advancing Chronic Care, Extenders and Social Services Act), which has extended CHIP for four more years.  The HEALTHY KIDS Act provisions remain in place in accordance with the January 2018 update below, with the following additions:
  • Funding for FFY 2024, 2025, 2026, and 2027;
  • Extension of the maintenance of effort (MOE) through 2027;
  • A new requirement for states to report quality measures in the child core set beginning in FFY 2024; and
  • Extension of the contingency fund, the qualifying state option, express lane eligibility, the pediatric quality measures program, and the outreach and enrollment program through FFY 2027.
Funding. Funding for CHIP is different beginning in FFY 2024. Rather than writing out a specific overall allotment amount each year, FFYs 2024-2027 are funded through what is known as “such sums” language. The new language is intended to cover all CHIP expenditures. Importantly, the final year of CHIP funding in this bill, FFY 2027, is written such that CBO will begin carrying $15.3B forward in the baseline rather than $5.7B, which more accurately reflects CHIP spending and should help make future CHIP funding extensions easier to offset.

Maintenance of Effort. As noted, the ACCESS Act extends the MOE through FFY 2027, picking up where the HEALTHY KIDS Act left off. The MOE remains as is – maintaining eligibility levels and enrollment procedures for children in Medicaid and CHIP – through FFY 2019 but beginning in FFY 2020 and beyond, states may scale back eligibility levels to 300 percent FPL.

Mandatory Quality Reporting. The new requirement for states to report pediatric quality measures for Medicaid and CHIP.  In 2016, 50 states reported at least one measure, 45 states reported at least half of the measures, but the median number of measures reported was only 18 (of 26). Further, CMS only releases data on measures reported by at least 25 states. Moving to mandatory reporting will make the quality data set more robust and much more useful for child health stakeholders.

These CHIP policies are estimated to save the federal government $4.85B.

CHIP coverage reauthorized through September 30, 2023
January 2018 - Congress passed and the President signed a continuing resolution (CR) on January 22, 2018, which included a 6-year extension of the CHIP through September 30, 2023.

The funding measure is similar to the CHIP bill that passed last fall in the House and includes, but is not limited to, the following:
  • Extends the qualifying state option, extends the express lane eligibility (ELE) state plan option, the childhood obesity demonstration project, the pediatric quality measures program and outreach and enrollment grants through 2023.
  • The 23% CHIP bump (increase in CHIP match rate – currently $.88 federal/$.12 state match in Alaska) will continue for 2 years and then be phased down, eventually to states’ regular enhanced CHIP match rate (the bump would be as it is in the current law through September 30, 2019, and then it will decrease to 11.5% through September 30, 2020 and after that, it will be eliminated and the match rate will return to states’ regular enhanced CHIP match rates, which is 15% points above the regular Medicaid match rate).
  • Keeps and extend the maintenance of effort/eligibility (MoE) provision through September 30, 2023, but after 2019 it will only apply to children in families up to 300% FPL.

About Denali KidCare: At September 30, 2018, 19,747 children were enrolled in Alaska’s Children’s Health Insurance Program (CHIP) known as Denali KidCare.  Effective April 1, 2019, children in families earning up to $5,446 per month (family of 4) may qualify for CHIP.  The Department of Health and Social Services administers Denali KidCare and Medicaid for children who qualify.