HR-3921 : Still Just a Bill

Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017 or the HEALTHY KIDS Act

This bill amends titles XI (General Provisions), XVIII (Medicare), XIX (Medicaid), and XXI (Children's Health Insurance Program) (CHIP) of the Social Security Act to extend funding for CHIP through FY2022 and otherwise revise CHIP, Medicaid, and Medicare.

The bill also extends funding through FY2022 for:

• the Child Enrollment Contingency Fund,
• the Childhood Obesity Demonstration Project,
• the Pediatric Quality Measures Program, and
• specified outreach and enrollment grants.

In addition, the bill reauthorizes through FY2022:

• the qualifying-states option (which allows states that provided coverage to now CHIP-eligible children prior to CHIP's enactment to continue to provide such coverage), and
• the express-lane eligibility option (which allows states to use eligibility findings from other public benefit programs to determine children's eligibility for Medicaid and CHIP).

Beginning in FY2020, the bill allows state child-health plans to adopt more restrictive eligibility standards with respect to children in families whose income exceeds 300% of the poverty line.

Current law provides states with an enhanced Federal Matching Assistance Percentage (FMAP) for child-health assistance through FY2019. The bill maintains the enhanced FMAP in FY2020, but halves the percentage-point increase.

The bill eliminates Medicaid payment reductions for disproportionate-share hospitals (which receive additional payment under Medicaid for treating a large share of low-income patients) in FY2018, but extends such reductions by two years (through FY2027).

The bill also increases Medicaid funding for Puerto Rico through FY2019. Such funding shall be further increased through 2019 if Puerto Rico takes specified actions to improve its Medicaid program.

In addition, the bill:

• alters provisions related to third-party liability under Medicaid and CHIP,
• specifies how a state must treat qualified lottery winnings and lump-sum income for purposes of determining Medicaid eligibility, and
• eliminates Medicare premium subsidies for beneficiaries with annual incomes exceeding $500,000.