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Preserving the Children's Health Insurance Program and Other Safety-Net Programs

As Congress debates legislation to repeal and replace the Affordable Care Act (ACA), a full range of stakeholders are attempting to predict the impact of these changes. Governors, state agencies, and state legislatures are working to finalize budgets for the upcoming fiscal year that, for most states, begins on July 1, 2017. Health care providers are trying to predict how changes will affect their revenues, and health insurers must set premiums within the next few months for services that will be covered in 2018. Finally, patients are hearing from some elected officials that they will lose coverage or access to certain services, while others are telling them that their coverage will be better and more affordable.

Funding for programs designed to improve coverage and access to care for vulnerable populations are set to expire on September 30, 2017. 

At the same time, funding for programs designed to improve coverage and access to care for vulnerable populations are set to expire on September 30, 2017. These include the Children’s Health Insurance Program, mandatory funding for community health centers and the National Health Service Corps, and the Maternal, Infant and Early-Childhood Home Visiting Program.

Without congressional action, mandatory funding for all four programs ceases at the end of Fiscal Year (FY) 2017. In addressing continued funding, policymakers must consider the implications of legislative timing, funding levels and duration of an extension, interactions with the ACA and Medicaid, and potential impacts on coverage for lower-income Americans.

Congress should initiate a process to examine a longer-term solution to health coverage for vulnerable populations.

This report highlights the importance of these bipartisan programs that serve vulnerable populations, recommends extending these programs at their current funding levels, and stresses the need for action early in the 115th Congress. Early action is needed to allow planning for FY2018, which for most states, begins July 1, 2017.

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