When the Senate returns it is hoped that they will quickly follow up on a March 26 approval by the House of Representatives to replace the Medicare SRG “doc fix” and also extend by two years two key programs: the home visiting program, MIECHV for two years and a two year extension of the CHIP program, the Children’s Health Insurance Program.

There has been some behind the scenes pushback on the part of some conservatives over the congressional break. The bill had overwhelming bipartisan support and was adopted by a vote of 392 to 37. The legislation (HR 2), will permanently replace what has become an almost annual ritual of supplanting the current provider payments through Medicare with a temporary restoration. It will also extend several significant programs. For many child advocates tow of the more important elements of the bill is a two year extension of the home visiting program, MIECHV and the CHIP program, the Children’s Health Insurance Program. The latter extension has drawn some concern by some advocates of CHIP who have been seeking a four year extension.

In addition to these two key programs the bill would permanently extend a transitional Medicaid assistance (TMA) program that assist TANF recipients when they leave cash assistance, another program that had received a variety of annual extensions. The bill would also extend funding for teen pregnancy prevention funding (PREP) and abstinence education funding and would extend funding for community health centers.

Although the cuts to doctors through Medicare took effect on April 1 HHS indicated that the provider cuts would not be imposed for a two week period. Earlier last month key Senate Finance Committee Democrats had indicated their unified opposition to the measure introduced in the House as negotiated due to the failure to extend CHIP for four years and some other issues but by week’s end that opposition seemed to be letting up.

Passage would extend the home visiting program an additional two years and combined would last year’s one year deal would appear to lift home visiting from the past partisan wars. Recently HHS released an Issue Brief which begins to shed light on the significant impact that the program is having in just a few short years. The number of children and parents served has risen from 34,180 in 2012 to 115,545 just two years later in 2014. In another measure, visits have increased from 174,257 to 746,303 visits by 2014 with the cumulative number of visits over the three years totals 1.4 million. Also of note:



  • Seventy nine percent of participating families had household incomes at or below 100 percent of poverty ($23,850 for a family of four),
  • 34 percent of adults had less than a high school degree and 35 percent and a high school degree
  • 27 percent of the newly enrolled household included pregnant teens,
  • 20 percent of the newly enrolled reported a history of child abuse and maltreatment, and
  • 12 percent of newly enrolled households reported substance abuse