T he State Children's Health Insurance Program (CHIP) is a federal-state program that provides health coverage to certain uninsured, low-income children and pregnant women in families that have annual income above Medicaid eligibility levels. CHIP is jointly financed by the federal government and the states and is administered by the states. Participation in CHIP is voluntary, and all states, the District of Columbia, and the territories participate. The federal government sets basic requirements for CHIP, but states have the flexibility to design their own version of CHIP within the federal government's basic framework. As a result, there is significant variation across CHIP programs. FY2017 was the last year federal CHIP funding was appropriated in statute, and FY2018 began on October 1, 2017, without CHIP funding being extended. As a result, states do not currently have full-year FY2018 CHIP allotments, and states are funding their CHIP programs with unspent federal CHIP funds from prior years. On October 4, 2017, both the Senate Finance Committee and the House Energy and Commerce Committee had markups on different bills that would extend CHIP federal funding through FY2022, among other things. The Senate Finance Committee reported the Keeping Kids' Insurance Dependable and Secure Act of 2017 (KIDS Act, S. 1827 ), which would extend federal CHIP funding through FY2022 and extend the increased enhanced federal medical assistance percentage (E-FMAP) rates for one year (i.e., through FY2020) but with an 11.5 percentage point increase instead of a 23 percentage point increase under current law. The bill also includes extensions of other CHIP provisions (e.g., the Express Lane eligibility option and the maintenance of effort [MOE] for children in families with incomes below 300% of the federal poverty level [FPL]) and other programs and demonstrations (e.g., the Child Obesity Demonstration Project and the Pediatric Quality Measures Program). According to the Congressional Budget Office (CBO) and the Joint Committee on Taxation (JCT) cost estimate, the KIDS Act is estimated to increase federal spending by $14.9 billion and revenues by $6.7 billion for a net cost of $8.2 billion over the period of FY2018 through FY2027. On January 5, 2018, CBO and JCT updated the cost estimate for the KIDS Act to account for the repeal of penalties for the individual health insurance mandate that was included in P.L. 115-97 , enacted on December 22, 2017. According to the cost estimate released on January 5, 2018, the KIDS Act is estimated to increase federal spending by $7.3 billion and revenues by $6.6 billion for a net cost of $0.8 billion over the period of FY2018 through FY2027. The House Energy and Commerce Committee reported the Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017 (HEALTHY KIDS Act, H.R. 3921 ), which includes almost identical language to the KIDS Act that would extend CHIP federal funding through FY2022 and extend the increased E-FMAP for one year at 11.5 percentage points. The HEALTHY KIDS Act also includes almost identical language that would extend the same CHIP provisions and other programs and demonstrations as the KIDS Act. The HEALTHY KIDS Act also includes some provisions that are not in the KIDS Act, such as adding a new CHIP state option for qualified CHIP look-alike plans; modifying the Medicaid disproportionate share hospital (DSH) allotment reductions; and providing additional Medicaid funding to Puerto Rico and the U.S. Virgin Islands. The HEALTHY KIDS Act includes the following provisions as offsets: modifications to Medicaid third party liability, treatment of lottery winnings for Medicaid eligibility, and Medicare Part B and D premium subsidies for higher-income individuals. On October 30, 2017, the House Rules Committee posted an amendment in the nature of a substitute for the Community Health And Medical Professionals Improve Our Nation Act of 2017 (CHAMPION Act, H.R. 3922 , H.Res. 601 ), meaning that it is intended to be considered by the House as an amendment to H.R. 3922 and the language of the CHAMPION Act would be stricken and the text of the amendment in the nature of the substitute would be inserted in its place. This amendment in the nature of a substitute is entitled the Continuing Community Health And Medical Professional Programs to Improve Our Nation, Increase National Gains, and Help Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act of 2017 (CHAMPIONING HEALTHY KIDS Act), and it includes revised language for the CHAMPION Act (which would extend funding for community health centers and other programs, among other things) under Division A and revised language for the HEALTHY KIDS Act under Division B. (See the textbox for an overview of the provisions in Division A of the CHAMPIONING HEALTHY KIDS Act.) The HEALTHY KIDS Act, under Division B of the CHAMPIONING HEALTHY KIDS Act, includes some changes to the provisions from the HEALTHY KIDS Act as reported by the House Energy and Commerce Committee. The CHAMPIONING HEALTHY KIDS Act amended the provision extending the outreach and enrollment program, the Medicaid DSH provision, and the Medicaid third party liability provision. In addition, the CHAMPIONING HEALTHY KIDS Act released on October 30, 2017, deleted the Medicare Parts B and D premium subsidies for higher-income individuals provision, but this provision was added back into the CHAMPIONING HEALTHY KIDS Act through an amendment adopted by the House Rules Committee on November 1, 2017. According to the CBO and JCT cost estimate for the CHAMPIONING HEALTHY KIDS Act language posted on the House Rules Committee website on October 30, 2017, the HEALTHY KIDS Act under Division B is estimated to increase federal spending by $11.4 billion and revenues by $6.7 billion for a net cost of $4.7 billion over the period of FY2018 through FY2027. The House passed the CHAMPIONING HEALTHY KIDS Act on November 3, 2017, by a vote of 242 to 174. This report contains a table that provides an overview of the provisions in the KIDS Act and Division B of the CHAMPIONING HEALTHY KIDS Act as baselined against current law. The section following the table provides more detailed summaries of the provisions in the KIDS Act and Division B of the CHAMPIONING HEALTHY KIDS Act. Table 1 provides a high-level comparison of the provisions in the KIDS Act and Division B of the CHAMPIONING HEALTHY KIDS Act. For each provision, there is a summary of current law, an explanation of the provision in the KIDS Act, and an explanation of how the provision in Division B of the CHAMPIONING HEALTHY KIDS Act compares to the provision in the KIDS Act. This section provides more detailed summaries of each provision in the KIDS Act and Division B of the CHAMPIONING HEALTHY KIDS Act. For each provision, there is a current law summary followed by an explanation of the provision in the KIDS Act. Then, there is an explanation of how the provision in Division B of the CHAMPIONING HEALTHY KIDS Act compares to the provision in the KIDS Act. CHIP is funded through FY2017 with appropriated amounts specified in statute. Since CHIP was first established in 1997, it has been funded through subsequent legislation. For instance, the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA; P.L. 111-3 ) provided federal CHIP funding for FY2009 through FY2013, the Patient Protection and Affordable Care Act (ACA; P.L. 111-148 , as amended) provided federal CHIP funding for FY2014 and FY2015, and the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA, P.L. 114-10 ) provided funding for FY2016 and FY2017. For FY2016 and FY2017, the annual appropriation amounts were $19.3 billion and $20.4 billion, respectively. The FY2017 appropriation was the combination of semiannual appropriations of $2.85 billion from Section 2104(a) of the Social Security Act (SSA) plus a one-time appropriation of $14.7 billion from MACRA Section 301(b)(3), which was provided for the first six months of the fiscal year and remains available until expended. Section 2(a) of the KIDS Act would extend federal CHIP funding for five years by adding federal appropriations for FY2018 through FY2022 under SSA Section 2104(a). The funding amounts are as follows: $21.5 billion for FY2018, $22.6 billion for FY2019, $23.7 billion for FY2020, $24.8 billion for FY2021, and $25.9 billion for FY2022. The funding for FY2022 would be structured as it was for FY2017, with semiannual appropriations of $2.85 billion plus a one-time appropriation (see " One-Time Appropriation for FY2022 ") in the amount of $20.2 billion to be provided for the first six months of the fiscal year and remain available until expended. Section 301(a) of the CHAMPIONING HEALTHY KIDS Act is identical to the provision in S. 1827 .