Children’s health advocates are cheering the Congressional Budget Office’s estimate that requiring one-year continuous enrollment for kids in Medicaid or CHIP under the Build Back Better plan will save nearly $3.7 billion over 10 years while making CHIP permanent will save about $1 billion. Meanwhile, it will cost $2.21 billion to extend coverage for postpartum women from 60 days after giving birth to one year.

The CBO released its final scoring of the reconciliation package on Thursday (Nov. 18) and estimated the two children’s health provisions could save billions of dollars. The CBO score for making CHIP permanent accounts only for costs in 2028 through 2031 because Congress last extended the program through 2027.

The score came out hours before the House was slated to vote on the Build Back Better package.

Children’s health advocates and lawmakers had worried CHIP would become a bargaining chip again during future budget negotiations if the program was not permanently extended.

“This score demonstrates why we need to do this now,” Bruce Lesley, First Focus on Children president, said in an email.“It currently saves about $1 billion. CBO estimates that CHIP is cheaper than the exchange for kids and that savings offsets the fact that they believe 2 million children would lose coverage altogether if CHIP expires.”

CHIP’s CBO score has more to do with what’s happening with the affordability of the exchanges, Medicaid or private sector rather than CHIP, Lesley said.

“However, as you saw, in the out-years a CHIP extension starts to cost money. Every year that passes leads to the possibility that CHIP becomes a ‘coster’ rather than a ‘saver,’” he added.

“We just need to get this done NOW so the health coverage of 10 million kids is not threatened by a future and ever-changing CBO score,” he said.

Advocates are also pushing lawmakers to pass 12-month continuous enrollment for children enrolled in Medicaid and CHIP. They’re worried minimal gains in kids’ enrollment in Medicaid or CHIP will vanish once the public health emergency ends and states resume kicking people, including children, off the rolls.

Continuous enrollment for one year decreases the chances of children being inappropriately removed from Medicaid and CHIP because families won’t have to undergo the renewal paperwork and bureaucracy hurdles as frequently.

CBO also estimated the maternal health provisions, including one-year postpartum coverage and investments in the perinatal workforce, will cost roughly $3 billion over 10 years. The latest version of the Build Back Better plan includes $954 million to provide a maternal health home for pregnant and postpartum women.

“This is a really landmark moment to ensure new moms and their babies are set up for a healthy lifetime, and to narrow longstanding disparities among new moms in Black, Latino and Indigenous communities,” Families USA said in an email. “Now Congress needs to get it done!”