Assessing the MACPAC report

By: Meg Booth

The Children’s Dental Health Project (CDHP) has previously reported on the threats to the Children's Health Insurance Program (CHIP) if funding is not extended past its current 2015 deadline. This week, the Medicaid and CHIP Payment and Access Commission (MACPAC) released their newest report to Congress, outlining the additional costs that families will likely face if CHIP ends.

MACPAC’s primary recommendation is for CHIP to be extended for two years, through 2017, at which time individuals enrolled in a separate CHIP plan would be rolled into the new insurance marketplaces created by the Affordable Care Act (ACA). This short window to resolve outstanding issues with ACA dental coverage causes us concern.

CDHP agrees with MACPAC that before children can be transitioned from CHIP into the marketplaces, key steps must be taken to ensure that these kids receive comparable benefits that are affordable.

MACPAC points to dental coverage as one of three key areas where CHIP and the Affordable Care Act’s (ACA) state marketplaces differ significantly. The report questions the comparability of benefits, cost-sharing, premiums, subsidies, and network adequacy  issues with which CDHP has previously raised concern. The Commission observes that while CHIP guarantees dental coverage, families may choose not to purchase pediatric dental plans offered on the marketplaces.

CDHP agrees with MACPAC that before children can be transitioned from CHIP into the marketplaces, key steps must be taken to ensure that these kids receive comparable benefits that are affordable. Appropriate changes in the ACA can facilitate this transition without putting undue strain on their families’ budgets.

  • First, we believe that MACPAC’s proposed two‐year extension of CHIP funding is unlikely to provide enough time for the necessary changes to achieve comparability between CHIP and the coverage available in the marketplaces. The ACA authorized CHIP through 2019; to ensure that children have uninterrupted dental coverage, funding should be aligned with this timeframe.

  • Second, more attention should be paid to the complications involved with transitioning children from CHIP to the marketplaces with respect to dental coverage. There is a stark difference in the affordability of pediatric dental benefits through CHIP versus marketplace coverage.

These and other concerns are explained in detail in CDHP’s recently released issue brief called CHIP’s Uncertain Future.

 

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