skip to main content

H.R. 3922: CHAMPION Act

Nov 3, 2017 at 11:06 a.m. ET. On Passage of the Bill in the House.

This was a vote to pass H.R. 3922 (115th) in the House.

H.R. 3922 extends funding for the Children’s Health Insurance Program (CHIP) through Fiscal Year (FY) 2022, Federally Qualified Health Centers (FQHCs) through FY2019, and revises CHIP and Medicaid.

Specifically the bill:

  • Extends funding through FY2022 for CHIP allotments, as well as the Child Enrollment Contingency Fund, the Childhood Obesity Demonstration Project, and Pediatric Quality Measures Program, and specified outreach and enrollment grants;
  • Reauthorizes through FY2022 the qualifying-states option and the express-land eligibility option;
  • Extends funding through FY2019 for FQHCs through the Community Health Center Fund;
  • Extends funding through FY2019 for the National Health Service Corps, Teaching Health Center Graduate Medical Education, Family-to-Family Health Information Centers, the Youth Empowerment Program, and the Personal Responsibility Education Program;
  • Allows state CHIP programs to adopt more restrictive eligibility standards with respect to children in families whose income exceeds 300% of the poverty line who have an offer of employer-sponsored insurance;
  • Ensures the unwinding of the enhanced Federal Matching Assistance Percentage (E-FMAP) for child-health assistance by not extending the E-FMAP beyond FY2019, providing a 11.5 percent E-FMAP in FY2020, and returning to the traditional pre-ACA CHIP matching rate in FY2021 and FY2022;
  • Eliminates Medicaid payment reductions for disproportionate-share hospitals (DSH allotments) in FY2018 and FY2019, and offsets the cost of this policy with new additional reductions in FY2021 through FY2023;
  • Increases Medicaid funding for Puerto Rico and the Virgin Islands through FY2019 and allows funding be further increased through 2019 if the oversight board certifies Puerto Rico takes specific actions to improve its Medicaid program’s quality, integrity, and accountability;
  • Allows states to define their grace period requirements for patients receiving advance premium tax credits (APTCs) and cost sharing reductions (CSRs) or move to a default of one month;
  • Redirects Prevention and Public Health Fund dollars to support critical prevention and public health programs in this bill;
  • Improves current law related to third-party liability under Medicaid and CHIP to save Medicaid and CHIP programs by ensuring other liable third parties pay to the extent of their liability;
  • Specifies how a state must treat qualified lottery winnings and lump-sum income for purposes of determining Medicaid eligibility.

Children’s Health Insurance Program (CHIP) – CHIP is a means-tested program that provides health coverage to targeted low-income children and some pregnant women in families that have annual income above Medicaid eligibility levels but have no health insurance[1]. CHIP is financed by the federal government and the states. The states are responsible for administering CHIP. Federal CHIP funding expired on September 30, 2017.

After the expiration of FY2017 funds, and until the provision of FY2018 funds, states may use redistributed funds and unspent allotments to continue to provide healthcare coverage, however at least one state is projected to exhaust all federal CHIP funding as early as November[2], and all states are expected to exhaust federal funding unless FY2018h funding is provided.

**Federal Qualified Health Centers (FQHCs) **– FQHCs, specifically, community health centers, are community-based, patient-centered organizations that provide comprehensive health services to medically-underserved populations, regardless of ability to pay. Funding for community health centers expired at the end of FY2017. This bill would extend funding for an additional two years.

**APTCs and CSRs Grace Period **– Under current law, subsidized patients with exchange plans have a three-month grace period if they do not pay their insurance premiums, meaning their plan cannot discontinue coverage for nonpayment of premiums[3]. H.R. 3922 allows states to define their own grace periods, or move to a default of one month.

**Prevention and Public Health Fund (PPHF) **– PPHF was created under the Affordable Care Act to fund “programs authorized for prevention, wellness, and public health activities”. H.R. 3922 allocates more than $6 billion from this fund to support public health programs under the bill[4].

Federal Matching Assistance Percentage – CHIP spending is by the federal government at a matching rate higher than that of the Medicaid program. This is known as the enhanced federal medical assistance percentage (E-FMAP). Under current law, a 23 percentage point increase in the CHIP federal matching rate that went into effect in FY2016 will expire at the end of FY2019. H.R. 3922 sets this E-FMAP at 11.5 in FY2020 and returns to CHIP’s historic matching rates beginning in FY2021.[5]

**DSH Allotments **– Under current law, allotments are made to states for payments to hospitals that treat a disproportionate share of uninsured and Medicaid patients. DSH allotments are increased each year by the percent change in the consumer price index and then will be adjusted by scheduled cuts between 2018 and 2025. H.R. 3921 eliminates the scheduled cuts for in FY2018 and FY2019, and offsets the cost of this policy with new additional reductions in FY2021 through FY2023.

Source: Republican Policy Committee

Totals

All Votes R D
Yea 58%
 
 
242
227
 
15
 
Nay 42%
 
 
174
3
 
171
 
Not Voting
 
 
16
8
 
8
 

Passed. Simple Majority Required. Source: house.gov.

Ideology Vote Chart

Key:
Republican - Yea Democrat - Yea Republican - Nay Democrat - Nay
Seat position based on our ideology score.

Cartogram Map

Each hexagon represents one congressional district. Solid hexes are Yea votes.

What you can do

Vote Details

Notes: The Speaker’s Vote? “Aye” or “Yea”?
Download as CSV

Statistically Notable Votes

Statistically notable votes are the votes that are most surprising, or least predictable, given how other members of each voter’s party voted and other factors.

All Votes

Study Guide

How well do you understand this vote? Use this study guide to find out.

You can find answers to most of the questions below here on the vote page. For a guide to understanding the bill this vote was about, see here.

What was the procedure for this vote?

  1. What was this vote on?
  2. Not all votes are meant to pass legislation. In the Senate some votes are not about legislation at all, since the Senate must vote to confirm presidential nominations to certain federal positions.

    This vote is related to a bill. However, that doesn’t necessarily tell you what it is about. Congress makes many decisions in the process of passing legislation, such as on the procedures for debating the bill, whether to change the bill before voting on passage, and even whether to vote on passage at all.

    You can learn more about the various motions used in Congress at EveryCRSReport.com. If you aren’t sure what the House was voting on, try seeing if it’s on this list.

  3. What is the next step after this vote?
  4. Take a look at where this bill is in the legislative process. What might come next? Keep in mind what this specific vote was on, and the context of the bill. Will there be amendments? Will the other chamber of Congress vote on it, or let it die?

    For this question it may help to briefly examine the bill itself.

What is your analysis of this vote?

  1. What trends do you see in this vote?
  2. Members of Congress side together for many reasons beside being in the same political party, especially so for less prominent legislation or legislation specific to a certain region. What might have determined how the roll call came out in this case? Does it look like Members of Congress voted based on party, geography, or some other reason?

    One tool that will be helpful in answering this question is the cartogram at the top of the page. A cartogram is a stylized map of the United States that shows each district as an identical hexagon. This view allows you to see the how the representatives from each district voted arranged by their geography and colored by their political party. What trends can you see in the cartogram for this vote?

  3. How did your representative vote?
  4. There is one vote here that should be more important to you than all the others. These are the votes cast by your representative, which is meant to represent you and your community. Do you agree with how your representative voted? Why do you think they voted the way they did?

    If you don’t already know who your Members of Congress are you can find them by entering your address here.

Each vote’s study guide is a little different — we automatically choose which questions to include based on the information we have available about the vote. Study guides are a new feature to GovTrack. You can help us improve them by filling out this survey or by sending your feedback to hello@govtrack.us.