The bill
CHIPP Act
HR. 1901, 119th Congress — read as touching Hospitals & Health Systems.
Sponsored by
Rep. Barragán, Nanette Diaz [D-CA-44]
ID: B001300
Follow the money
The bill
HR. 1901, 119th Congress — read as touching Hospitals & Health Systems.
The sponsor
Every bill has someone who introduced it. That name is where the paper trail starts.
The alignment
This bill's text tracks the "Department of Health and Human Services" section, p. 509-511 of the Mandate for Leadership.
Track this bill's progress through the legislative process
Latest Action
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📍 Current Status
Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.
1. Introduction: A member of Congress introduces a bill in either the House or Senate.
2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.
3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.
4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.
5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.
6. Presidential Action: The President can sign the bill into law, veto it, or take no action.
7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!
Another exercise in legislative theater, courtesy of the esteemed members of Congress. Let's dissect this farce, shall we?
**Main Purpose & Objectives:** The CHIPP Act (HR 1901) claims to "permanently extend" the Children's Health Insurance Program (CHIP). How noble. In reality, it's a thinly veiled attempt to lock in funding for a program that's been perpetually extended since its inception in 1997. The real objective? To create a permanent entitlement program, ensuring a steady stream of votes and campaign contributions from special interest groups.
**Key Provisions & Changes to Existing Law:** The bill makes several "technical" changes to the Social Security Act, effectively removing expiration dates for various programs and demonstration projects. These include:
* Permanently extending CHIP funding * Reauthorizing the Pediatric Quality Measures Program * Modifying the Express Lane Eligibility Option * Altering the Assurance of Affordability Standard for Children and Families
These changes are nothing more than a shell game, designed to obscure the true intent: to create an unending stream of taxpayer dollars for favored programs.
**Affected Parties & Stakeholders:** The usual suspects:
* CHIP beneficiaries (i.e., low-income families with children) * Healthcare providers * Insurance companies * Lobbyists and special interest groups
Each of these stakeholders will, no doubt, be showered with campaign contributions and promises of "support" in exchange for their acquiescence.
**Potential Impact & Implications:** The CHIPP Act will:
* Increase the national debt by billions (but who's counting?) * Create a permanent entitlement program, ensuring a steady stream of votes and campaign contributions * Further entrench the interests of healthcare providers, insurance companies, and lobbyists * Do little to address the underlying issues plaguing our healthcare system
In short, this bill is a masterclass in legislative cynicism. It's a calculated attempt to buy votes, curry favor with special interest groups, and perpetuate the status quo. The American people will be left footing the bill for this farce, while the politicians and lobbyists reap the rewards.
Diagnosis: Terminal case of Legislative Larceny, with symptoms including Chronic Vote-Buying, Acute Special Interest-itis, and a severe lack of fiscal responsibility. Prognosis: Poor.
No campaign finance data available for Rep. Barragán, Nanette Diaz [D-CA-44]
Which industries are materially affected by specific provisions in this bill. 2 helped, 1 harmed.
Section 2 permanently extends CHIP funding, which increases reimbursement for pediatric services provided by hospitals and health systems.
Section 2 extends CHIP allotments, reducing pressure on private insurers to cover children and stabilizing Medicaid/CHIP enrollment.
Section 3(e) modifies outreach and enrollment programs, potentially reducing reliance on third-party contractors (including for-profit entities) for CHIP enrollment assistance.
This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.
AI Analysis:
"Both the CHIPP Act and the Project 2025 HHS section aim to improve outcomes for low-income children and families, but they address different policy levers—health insurance versus welfare work requirements, teen pregnancy prevention, and adoption reform—resulting in only moderate thematic overlap."
— 476 — Mandate for Leadership: The Conservative Promise l Pay damages to all medical professionals who were dismissed directly because of the CMS vaccine mandate. ADMINISTRATION FOR CHILDREN AND FAMILIES (ACF) TANF. The Temporary Assistance for Needy Families (TANF) program is a federal block grant that gives states significant flexibility to fund a broad array of programs aimed at helping low-income families break the cycle of poverty and achieve economic self-sufficiency. States use TANF to fund monthly cash assis- tance payments to low-income families with children as well as a wide range of services that include work activities, work supports and supportive services, child- care, administration and systems, tax credits, pre-K/Head Start, child welfare, and other services. The TANF program serves 1.8 million individuals. Since 1996, when the program was reformed, federal TANF outlays have been $16.5 billion. The state match is $14.9 billion, bringing the total state and federal TANF investment to $31.4 billion. The TANF statute requires that states engage 50 percent of single-parent fam- ilies in work for at least 30 hours a week (20 hours a week for single parents with children under age six, though states have the option to waive the requirement for families with children under the age of six, and most do). States also have 90 percent work requirements for two-parent families to engage in work for 35 hours per week. Because of the “Caseload Reduction Credit,” states’ work engagement targets are reduced if their assistance caseloads have fallen since 2005. As a result, 21 states had a work engagement target of zero percent in 2017. Generally, states apply their work requirement only to beneficiaries receiv- ing basic assistance, who account for 22.3 percent of TANF outlays. The Trump Administration proposed a Supplemental Nutrition Assistance Program (SNAP) rule to “increase program integrity and reduce fraud, waste, and abuse” that would have prevented an individual from qualifying for SNAP simply because he or she received a pamphlet from the TANF program.60 This rule defined non-cash benefits as those that are worth at least $50 a month and received for at least six months. The tenets of this rule should be applied to the TANF program as well. This defi- nitional change would apply the TANF work requirements to any noncash benefit worth $50 a month and received for six consecutive months. To increase transparency, HHS should clarify how states, in their quarterly and annual reports, ought to track and audit the outcomes from how they spend TANF funds to meet the TANF program’s four statutory purposes. Additionally, TANF priorities are not implemented in an equally weighted way. Marriage, healthy family formation, and delaying sex to prevent pregnancy are virtually ignored in terms of priorities, yet these goals can reverse the cycle of poverty in meaningful ways. CMS should require explicit measurement of these goals. — 477 — Department of Health and Human Services Teen Pregnancy Prevention (TPP) and Personal Responsibility Educa- tion Program (PREP). TPP is operated by the Office of Population Affairs in the Office of the Assistant Secretary for Health; PREP is operated by the ACF Office of Planning, Research, and Evaluation. Both programs should ensure that there is better reporting of subgrantees and referral lists so that they do not promote abortion or high-risk sexual behavior among adolescents. CMS should ensure that Sexual Risk Avoidance (SRA) proponents receive these grants and are given every opportunity to prove their effectiveness. SRA programs, both at ACF and at OASH and both discretionary and mandatory, should be equal in funding and emphasis. Qualitative research should be conducted on both types of programs to ensure continuous improvement. In addition, certain provisions should be employed so that these programs do not serve as advocacy tools to promote sex, promote prostitution, or provide a funnel effect for abortion facilities and school field trips to clinics, or for similar purposes. Parent involvement and parent–child communication should be encour- aged and be a part of any funded project. Risk avoidance should be prioritized, and any program that submits a proposal that promotes risk rather than health should not be eligible for funding. Site visits should be revamped to ensure adherence to these optimal health met- rics, and a cost analysis of programming as compared to students served should be a metric in funding (taking into account that in certain cases, intensive programs will serve fewer students and can have more positive results). These same param- eters should apply to sex education programs at ACF. Any lists with “approved curriculum” or so-called evidence-based lists should be abolished; HHS should not create a monopoly of curriculum, adding to the profit of certain publishers. Furthermore, lists created in the past have given priority to sex-promotion text- books. HHS should create a list of criteria for evaluating the sort of curriculum that should be selected for any sex education grant programs, both at OASH and at ACF, with the aim of promoting optimal health and adhering to the legislative language of each program. Adoption Reform. There are roughly 400,000 children across the nation on the waiting list for foster care and 100,000 awaiting adoptive families, and the opioid/ fentanyl crisis is putting more at risk every day. Unfortunately, many of the faith- based adoption agencies that serve these children are under threat from lawsuits, or else their licenses and contracts have been halted because they cannot in good conscience place children in every household due to their religious belief that a child should have a married mother and father. HHS, through ACF and the Assistant Secretary for Financial Resources (ASFR), should repeal the unnecessary 2016 regulation61 that imposes nonstatutory sexual orientation and gender identity nondiscrimination conditions on agency grants and return to the policy of maximizing the options for placing vulnerable children
AI Analysis:
"The CHIPP Act focuses on extending healthcare access for low-income children and pregnant women through permanent CHIP funding, while the Project 2025 HHS section emphasizes abortion restrictions, conscience protections, gender-affirming care limitations, and civil rights rollbacks—areas not addressed in the bill. There is minimal thematic overlap beyond general HHS jurisdiction."
— 501 — Department of Health and Human Services 54. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Office of Civil Rights, and Office of the Secretary, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,” draft of Proposed Rule, January 14, 2021, https://www.hhs.gov/sites/default/files/infants-nprm.pdf (accessed March 17, 2023). 55. H.R. 26, Born-Alive Abortion Survivors Protection Act, 118th Congress, introduced January 9, 2023, https:// www.congress.gov/118/bills/hr26/BILLS-118hr26pcs.pdf (accessed March 17, 2023). 56. H.R. 7, No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2023, 118th Congress, introduced January 9, 2023, https://www.congress.gov/118/bills/hr7/BILLS-118hr7ih.pdf (accessed March 17, 2023). 57. S. 401, Conscience Protection Act of 2021, 117th Congress, introduced February 24, 2021, https://www.congress. gov/117/bills/s401/BILLS-117s401is.pdf (accessed March 17, 2023). 58. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, and Office of the Secretary, “Nondiscrimination in Health Programs and Activities,” Notice of Proposed Rulemaking; Notice of Tribal Consultation, Federal Register, Vol. 87, No. 149 (August 4, 2022), pp. 47824–47920, https://www.govinfo. gov/content/pkg/FR-2022-08-04/pdf/2022-16217.pdf (accessed March 17, 2023). 59. Ibid., p. 47916. 60. The regulation was not finalized before the end of the Administration. U.S. Department of Agriculture, Food and Nutrition Services, “Revision of Categorical Eligibility in the Supplemental Nutrition Assistance Program (SNAP),” Proposed Rule, Federal Register, Vol. 84, No. 142 (July 24, 2019), pp. 35570–55581, https:// www.federalregister.gov/documents/2019/07/24/2019-15670/revision-of-categorical-eligibility-in-the- supplemental-nutrition-assistance-program-snap (accessed March 17, 2023). 61. 45 Code of Federal Regulations § 75.300(c) and (d), https://www.ecfr.gov/current/title-45/subtitle-A/ subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.300 (accessed March 17, 2023). 62. H.R. 1750, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https:// www.congress.gov/117/bills/hr1750/BILLS-117hr1750ih.pdf (accessed March 17, 2023), and S. 656, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https://www.congress.gov/117/bills/ s656/BILLS-117s656is.pdf (accessed March 17, 2023). 63. S. 3949, Trafficking Victims Protection Reauthorization Act of 2022, Public Law No. 117-348, 117th Congress, January 25, 2023, https://www.congress.gov/117/plaws/publ348/PLAW-117publ348.pdf (accessed March 17, 2023). 64. Kelsey Y. Santamaria, “Child Migrants at the Border: The Flores Settlement Agreement and Other Legal Developments,” Congressional Research Service In Focus No. IF11799, April 1, 2021, https://crsreports.congress. gov/product/pdf/IF/IF11799 (accessed March 17, 2023). 65. Report, Building a Happy Home: Marriage Education as a Tool to Strengthen Families, Social Capital Project Report No. 1-22, March 2022, p. 17, https://www.jec.senate.gov/public/_cache/files/3d102525-6f0d-48ed- 92f4-d71edd468ad6/building-a-happy-home.pdf (accessed March 17, 2023). The cover of the report reflects that the Social Capital Project is “[a] project of the Joint Economic Committee – Republicans.” 66. See, for example, Alan J. Hawkins, “Are Federally Supported Relationship Education Programs for Lower-Income Individuals and Couples Working? A Review of Evaluation Research,” American Enterprise Institute, September 2019, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 67. H.R. 8404, Respect for Marriage Act, Public Law No. 117-228, 117th Congress, December 13, 2022, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 68. Madison Marino, “Over 1,000 Safety Violations Mar Head Start. Children Deserve Better,” Heritage Foundation Commentary, November 10, 2022, https://www.heritage.org/education/commentary/over-1000-safety- violations-mar-head-start-children-deserve-better. 69. American Hospital Association v. Becerra, 596 U.S. ___ (2022), https://www.supremecourt.gov/ opinions/21pdf/20-1114_09m1.pdf (accessed March 17, 2023). 70. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, “Coverage of Certain Preventive Services Under the Affordable Care Act,” Notice of Proposed Rulemaking, Federal Register, Vol. 88, No. 22 (February 2, 2023), pp. 7236–7281, https://www. govinfo.gov/content/pkg/FR-2023-02-02/pdf/2023-01981.pdf (accessed March 17, 2023). — 502 — Mandate for Leadership: The Conservative Promise 71. 42 U.S. Code § 238n, https://www.law.cornell.edu/uscode/text/42/238n (accessed March 17, 2023). 72. U.S. Department of Health and Human Services, Health Resources and Services Administration, “Early Childhood Health,” last reviewed October 2022, https://mchb.hrsa.gov/programs-impact/focus-areas/early- childhood-health (accessed March 17, 2023). 73. American Pregnancy Association, “Having a Doula—What Are the Benefits?” https://americanpregnancy. org/healthy-pregnancy/labor-and-birth/having-a-doula/#:~:text=Other%20studies%20have%20shown%20 that%20having%20a%20doula,massage%20to%20reduce%20stress%20and%20anxiety%20during%20labor (accessed March 17, 2023). 74. S. 2372, VA MISSION [Maintaining Internal Systems and Strengthening Integrated Outside Networks] Act of 2018, Public Law No. 115-182, 115th Congress, June 6, 2018, https://www.congress.gov/115/plaws/publ182/ PLAW-115publ182.pdf (accessed March 17, 2023). 75. U.S. Department of Health and Human Services, “Securing Updated and Necessary Statutory Evaluations Timely,” Final Rule, Federal Register, Vol. 86, No. 11 (January 19, 2021), pp. 5694–5764, https://www.govinfo. gov/content/pkg/FR-2021-01-19/pdf/2021-00597.pdf (accessed March 22, 2023). 76. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Compliance with Statutory Program Integrity Requirements,” Final Rule, Federal Register, Vol. 84, No. 42 (March 4, 2029), pp. 7714–7791, https://www.govinfo.gov/content/pkg/FR-2019-03-04/pdf/2019-03461.pdf (accessed March 18, 2023). 77. U.S. Department of Health and Human Services, Office of the Secretary, Office of the Assistant Secretary for Health, “Ensuring Access to Equitable, Affordable, Client-Centered, Quality Family Planning Services,” Final Rule, Federal Register, Vol. 86, No. 192 (October 7, 2021), pp. 56144–56180, https://www.govinfo.gov/content/ pkg/FR-2021-10-07/pdf/2021-21542.pdf (accessed March 18, 2023). 78. S. 624, Title X Abortion Provider Prohibition Act, 118th Congress, introduced March 2, 2023, https://www. congress.gov/118/bills/s624/BILLS-118s624is.pdf (accessed March 18, 2023). 79. 50 U.S. Code Chapter 55, https://www.law.cornell.edu/uscode/text/50/chapter-55 (accessed March 22, 2023). 80. 18 U.S. Code § 13, https://www.law.cornell.edu/uscode/text/18/13 (accessed March 18, 2023). 81. Bowen v. American Hospital Association, 476 U.S. 610 (1986), https://tile.loc.gov/storage-services/service/ll/ usrep/usrep476/usrep476610/usrep476610.pdf (accessed 22, 2023). 82. U.S. Department of Health and Human Services, Office of the Secretary, “Notification of Interpretation and Enforcement of Section 1557 of the Affordable Care Act and Title IX of the Education Amendments of 1972,” Federal Register, Vol. 86, No. 99 (May 25, 2021), pp. 27984–27985, https://www.govinfo.gov/content/pkg/FR- 2021-05-25/pdf/2021-10477.pdf (accessed March 18, 2023). 83. U.S. Department of Health and Human Services, Office for Civil Rights, “HHS Notice and Guidance on Gender Affirming Care, Civil Rights, and Patient Privacy,” March 2, 2022, https://www.hhs.gov/sites/default/files/hhs- ocr-notice-and-guidance-gender-affirming-care.pdf (accessed March 18, 2023). 84. Heckler v. Chaney, 420 U.S. 821 (1985), https://caselaw.findlaw.com/us-supreme-court/470/821.html (accessed March 18, 2022). 85. U.S. Department of Health and Human Services, Office for Civil Rights, “Guidance to Nation’s Retail Pharmacies: Obligations Under Federal Civil Rights Laws to Ensure Access to Comprehensive Reproductive Health Care Services,” content last reviewed July 14, 2022, https://www.hhs.gov/civil-rights/for-individuals/ special-topics/reproductive-healthcare/pharmacies-guidance/index.html (accessed March 18, 2023). 86. H.R. 3103, “Health Insurance and Portability and Accountability Act of 1996, Public Law No. 104-191, 104th Congress, August 21, 1996, https://www.congress.gov/104/plaws/publ191/PLAW-104publ191.pdf (accessed March 18, 2023). 87. U.S. Department of Human Services, “HIPAA Privacy Rule and Disclosures of Information Relating to Reproductive Health Care,” content last reviewed June 29, 2022, (accessed March 18, 2023). See also “Protecting the Privacy and Security of Your Health Information When Using Your Personal Cell Phone or Tablet,” content last reviewed June 29, 2022, https://www.hhs.gov/hipaa/for-professionals/privacy/guidance/ cell-phone-hipaa/index.html (accessed March 18, 2023).
AI Analysis:
"The CHIPP Act seeks permanent funding and stability for CHIP and related pediatric programs, whereas the Project 2025 HHS section emphasizes Medicaid work requirements, private insurance options, and benefit redesign. Both address low‑income health coverage, but their policy directions diverge significantly."
— 468 — Mandate for Leadership: The Conservative Promise and consumer choice for Medicaid recipients must go together as standard components of the safety net, especially for able-bodied recipients. Medicaid recipients, like the rest of Americans, should be given both the freedom to choose their health plans and the responsibility to contribute to their health care costs at a level that is appropriate to protect the taxpayer. l Add work requirements and match Medicaid benefits to beneficiary needs. Because Medicaid serves a broad and diverse group of individuals, it should be flexible enough to accommodate different designs for different groups. For example, CMS should launch a robust “personal option” to allow families to use Medicaid dollars to secure coverage outside of the Medicaid program. CMS should also: 1. Clarify that states have the ability to adopt work incentives for able- bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees. 2. Add targeted time limits or lifetime caps on benefits to disincentivize permanent dependence.34 l Allow private health insurance. Congress should allow states the option of contributing to a private insurance benefit for all members of the family in a flexible account that rewards healthy behaviors. This reform should also allow catastrophic coverage combined with an account similar to a health savings account (HSA) for the direct purchase of health care and payment of cost sharing for most of the population. l Increase flexible benefit redesign without waivers. CMS should add flexibility to eliminate obsolete mandatory and optional benefit requirements and, for able-bodied recipients, eliminate benefit mandates that exceed those in the private market. This should include flexibility to redesign eligibility, financing, and service delivery of long-term care to serve the most vulnerable and truly needy and eliminate middle-income to upper- income Medicaid recipients. l Eliminate current waiver and state plan processes. CMS should allow providers to make payment reforms without cumbersome waivers or state plan amendment processes where possible. More broadly, the federal government’s role should be oversight on broad indicators like cost effectiveness and health measures like quality, health improvement, and — 469 — Department of Health and Human Services wellness and should give the balance of responsibility for Medicaid program management to states. This reform would include adding Section 111535 waiver requirements in some cases (such as imposing work requirements for able-bodied adults) while rescinding requirements in others (such as non–health care benefits and services related to climate change). AFFORDABLE CARE ACT AND PRIVATE HEALTH INSURANCE l Remove barriers to direct primary care. Direct primary care (DPC) is an innovative health care delivery model in which doctors contract directly with patients for their care on a subscription basis regardless of how or where the care is provided. The DPC model is improving patient access, driving higher quality and lower cost, and strengthening the doctor– patient relationship. DPC has faced many challenges from government policymakers, including overly exuberant attempts at regulation and misclassification. Changes should clarify that DPC’s fixed fee for care does not constitute insurance in the context of health savings accounts.36 l Revisit the No Surprises Act on surprise medical billing. The No Surprises Act37 protected consumers against balance bills, but it also established a deeply flawed system for resolving payment disputes between insurers and providers. This government-mandated dispute resolution process has sown confusion among arbiters and regulators as judges have sought to ascertain its meaning. The No Surprises Act should scrap the dispute resolution process in favor of a truth-in-advertising approach that will protect consumers and free doctors, insurers, and arbiters from confused and conflicting standards for resolving disputes that the disputing parties can best resolve themselves.38 l Facilitate the development of shared savings and reference pricing plan options. Under traditional insurance, patients who choose lower- cost care do not benefit financially from that choice. Barriers to rewarding patients for cost-saving decisions should be removed. CMS should ensure that shared savings and reference pricing models that reward consumers are permitted. l Separate the subsidized ACA exchange market from the non- subsidized insurance market. The Affordable Care Act has made insurance more expensive and less competitive, and the ACA subsidy scheme simply masks these impacts. To make health insurance coverage more affordable for those who are without government subsidies, CMS should develop a plan to separate the non-subsidized insurance market
Showing 3 of 5 policy matches
Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.