On Thursday, March 26 the House of Representatives took up the SRG “doc fix” bill and passed it in overwhelming bipartisan fashion by a vote of 392 to 37. The legislation (HR 2), if enacted, will not only permanently replace what has become an almost annual ritual of supplanting the current provider payments through Medicare with a temporary restoration, but will also extent several significant programs.

Two of the key extensions include an extension of the home visiting program, MIECHV for two years and a two year extension of 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.

The Senate is expected to take up the measure when they return from break.  The cuts to doctors through Medicare take effect on April 1 but there appears to be some flexibility for HHS in that the provider cuts may not be imposed for a two week period.  A week earlier 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.  The House measure had overwhelming support and President Obama had praised the measure earlier in the week.

Passage would extend the home visiting program an additional two years and combined with last year’s one year deal would appear to lift home visiting from the past partisan wars.  Recently HHS released an

Issue brief which sheds 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