Medicaid and SCHIP: Recent HHS Approvals of Demonstration Waiver Projects Raise Concerns

摘要

This report includes three matters for congressional consideration. The Congress should consider amending title XXI of the Social Security Act to (1) specify that SCHIP funds are not available to provide health insurance coverage for childless adults and (2) establish, for parents or guardians of SCHIP-eligible children, which statutory objectives should take precedencethose of title XXI to provide family coverage only if it is cost effective, or those of section 1115 that allows the Secretary to waive the cost effectiveness test. The Congress should also consider requiring the Secretary of HHS to improve the federal public notification and input process for state Medicaid and SCHIP section 1115 demonstration proposals under consideration.