H.R. 3921 would extend federal funding for the Children’s Health Insurance Program (CHIP) for five years, increase Medicaid funding for Puerto Rico and the Virgin Islands, and change policies that require other sources of health coverage to pay claims before Medicaid. The bill also would modify payments to hospitals that treat a disproportionate share of uninsured and Medicaid patients and require states to count lottery winnings as income for purposes of determining Medicaid eligibility. Finally, H.R. 3921 would make adjustments to Medicare premium subsidies for higher-income individuals.
On net, CBO estimates that implementing the legislation would reduce the deficit by $1.1 billion over the 2018-2027 period. Because enacting H.R. 3921 would affect direct spending and revenues, pay-as-you-go procedures apply.
CBO estimates that enacting H.R. 3921 would not increase net direct spending or on-budget deficits in one or more of the four consecutive 10-year periods beginning in 2028.
H.R. 3921 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act.