Bill lets thousands of kids keep CHIP

Rep. Dent of Pa. targets Medicaid rule in Obamacare

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WASHINGTON -- A bill sponsored by Rep. Charlie Dent of Pennsylvania could allow children to retain their state health insurance for the long haul rather than transfer to Medicaid, as the Affordable Care Act calls for.

In Pennsylvania, the legislation would affect about 30,000 of the 190,000 children covered by CHIP, the Children's Health Insurance Program.

The legislation would eliminate a Medicaid coverage requirement in the Affordable Care Act that applies to children whose families earn between 100 percent and 133 percent of the federal poverty level. For a family of four, that would be between $23,550 and $31,322.

The proposal by Mr. Dent, R-Allentown, strikes the Affordable Care Act provision that extends Medicaid eligibility to everyone earning less than 133 percent of the federal poverty level and providing almost all the money needed to fund the expansion.

Pennsylvania already got deferment last week when the Department of Health and Human Services approved a one-year delay requested by Gov. Tom Corbett to give families time to make the switch.

But Mr. Dent and Mr. Corbett, also a Republican, want a permanent reprieve. The congressman's legislation would provide that, and would allow children nationwide to stay on their states' subsidized insurance programs as well.

Spokesmen for the White House and Health and Human Services had no immediate comment Monday.

Mr. Dent stumped for his bill Monday afternoon at the Penn State Milton S. Hershey Medical Center, then returned to Washington to formally introduce it Monday evening.

Mr. Corbett, who joined him for the news conference in Hershey, has complained that the shift would be disruptive because some families would have to find new doctors that accept Medicaid patients.

"My goal is to ensure less disruption of care and ultimately provide choice to Pennsylvania's families," the governor said in a statement Monday.

In a phone interview, Mr. Dent said families prefer CHIP, which is administered by private insurers and funded by a mix of state and federal dollars along with family-paid premiums on a sliding scale that begins at zero. Many pediatricians won't accept Medicaid because of payment delays and bureaucratic hassles, he said.

"Medicaid is notorious for underpaying providers," he said.

Allies for Children, a southwestern Pennsylvania advocacy group, says Congress should work on strengthening Medicaid if policy leaders believe it isn't working well.

Five times more Pennsylvania children are enrolled in Medicaid than CHIP.

"It's very clear that Rep. Dent and Gov. Corbett do not feel that Medicaid is providing a quality form of health care for children," said Patrick Dowd, Allies for Children's executive director. "If Medicaid is a comparatively substandard option, we should not be asking the question about how do we keep children from moving from CHIP to Medicaid without asking how do we make Medicaid the kind of program we want it to be."

His organization hasn't taken a position on Mr. Dent's legislation but does note that Medicare has more robust coverage, particularly for mental health.

Mr. Dent acknowledged the differences in coverage.

"People say Medicaid has a better benefit structure than CHIP. That may be true, but you can't access that benefit structure if the physician won't see you," he said. "CHIP is an easier system to navigate, and there's better access."

Bureau Chief Tracie Mauriello:, 703-996-9292 or on Twitter @pgPoliTweets.

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