The Consequences Of Repealing Medicaid’s Maintenance Of Effort Provision

Out of the many troubling health care repeal amendments in the Korean trade agreement, Sen. Orrin Hatch’s (R-UT) proposal to repeal the maintenance of effort provision for the Medicaid program — which requires states to maintain their enrollment numbers or risk losing federal funding — is possibly the most egregious. It encompasses the Republican approach of “saving” the program by forcing more people off of it — no matter the consequences to the beneficiaries.

As Sen. Jay Rockefeller (D-WV) pointed out in a recent letter to Hatch, according to the Congressional Budget Office, the provision would result in substantial coverage erosion for children in the CHIP program:

— By 2013, 400,000 people will lose their Medicaid and CHIP coverage. Two thirds of those dropped from coverage will be children.

Half of all states will end their CHIP programs by 2016. One quarter of states are expected to end their program even earlier, in 2015, while remaining CHIP programs are expected to scale back coverage.

— By 2016, the number of those expected to lose CHIP coverage will climb to 1.7 million people, with 700,000 left uninsured.

Interestingly, as a long-time proponent of extending health care coverage to children and a co-sponsor of the original CHIP bill in 1997, the Hatch of yesteryear would have opposed these cuts. Here he is in 2006, praising the program on its 10-year anniversary: “When we drafted this legislation in 1997, our goal was to cover the several million children who had no insurance coverage. We have gone a long way in meeting that goal, but we are clearly not there yet. Coverage of these uninsured children should still be our top priority.”