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Win-Win: Continuous Healthcare Coverage Improves Health and Saves Money

In the latest report from Georgetown University Center for Children and Families’ series on the future of children’s health coverage, the authors highlight the many benefits of continuous health insurance coverage for children, especially in Medicaid and CHIP. This policy – known as “continuous eligibility” – allows enrollees to maintain health coverage for a full 12 months and can counteract common and unnecessary disruptions in Medicaid coverage due to difficulty navigating the renewal process or fluctuations in monthly income.

Cycling on and off of Medicaid, a process known as “churning,” creates gaps in health care coverage that ultimately cause several adverse outcomes, including worsening chronic health conditions, higher administrative expenses, and increased costs for managed care organizations (MCOs).

Research has shown that continuous eligibility policy is not only linked with favorable health outcomes but also has considerable cost savings as well:

• Individuals who lose Medicaid coverage and then reenroll after going without health care often face more expensive healthcare costs than if they had received continuous coverage. Studies have shown an estimated cost for one month of $705 compared to an estimated monthly cost of $326 for those enrolled continuously for 12 months.
• Reducing administrative burdens of processing terminations and subsequent reenrollment applications is estimated to save an average of $400 to $600 per individual. Those savings could be used for healthcare costs as better use of resources within Medicaid.

Currently, 27 states have continuous eligibility for children in CHIP, and 25 states have it for children in Medicaid. Pennsylvania has continuous eligibility for all children in CHIP but only children younger than age 4 in Medicaid.

An important note during the COVID pandemic is that the disenrollment freeze allowed through the Families First Coronavirus Response Act provides for continuous enrollment during the federal public health emergency (PHE), which was just renewed again. When the PHE is lifted (not expected before January 2022) and the regular enrollment process resumes, PPC will continue to advocate for the advancement of continuous eligibility policy.

To ensure this policy is fully achieved, PPC is advocating to expand continuous eligibility in Pennsylvania to all children in Medicaid following the public health emergency.

Bipartisan Infrastructure Deal Garners Passage in Senate; House Poised to Weigh In

Significant forward progress was made in recent days in the long progression for the federal government to make historic investments in the nation’s infrastructure, with Democratic leaders in the Senate rushing to move the bipartisan-supported bill through the chamber before leaving Washington for its August recess next Monday (August 9th). Procedural votes on the agreed-to proposal, including on several amendments, began yesterday and will continue through the next few days.

With the 2,700-page bill text just released yesterday, the framework calls for $1 trillion in federal spending ($550 billion in new spending) on traditional infrastructure projects like roads, railways, public transit, bridges and broadband, while less traditional elements initially championed by the Biden administration – including funds for child care initiatives (such as employer tax credits for locating a child care facility on-site) – were left on the cutting room floor. Funding for some lead remediation efforts, particularly around water pipes, is included in the current language.

Should the Senate succeed in passing the infrastructure bill in an expedited fashion, the U.S. House has already adjourned for its August recess and will not return until September 20^th – meaning it will still be some time until the legislation reaches the president’s desk.

This first bipartisan bill is a foray into what is expected to be a bigger battle coming this fall for the Biden Administration and Democratic congressional leaders on the larger federal spending plan, totaling more than $3 trillion. With that legislation, Democrats will work to pass a bill using the budget reconciliation process (read: no Republican votes are needed with Vice President Kamala Harris able to cast the tie-breaking vote in the Senate).

The second spending proposal – which Senate Majority Leader Chuck Schumer indicated may also start to see some movement in the chamber this week – incorporates much of President Biden’s American Families Plan, providing enhanced spending for many early childhood initiatives, including:

• Creating a free, universal pre-k program for all 3- and 4-year-olds.
• Capping the cost of high-quality child care for families to no more than 7% of their income and addressing early care and education workforce issues, including pay.
• Permanently extending the Child Tax Credit and the Child Care and Dependent Tax Credit and expanding the amounts of the former initiative.
• Instituting 12 weeks of paid family and medical leave.

PPC is currently meeting (virtually) with members of our congressional delegation and their staff to talk about the importance of investing in child care in the long term, setting the stage for the need for reauthorization and funding of the Maternal, Infant, and Early Childhood Home Visiting (MIECHV) program needed by next September, and the importance of the child tax credits for families. We will continue to provide updates as these proposals move through the federal legislative process.