Medicaid and CHIP Payment and Access Commission

Medicaid and CHIP Payment and Access Commission
Agency overview
FormedFebruary 4, 2009; 17 years ago (2009-02-04)
Headquarters
  • 1800 M Street NW, Suite 650 South
    Washington, D.C. 20036
Agency executives
  • Verlon Johnson, Chair
  • Robert Duncan, Vice Chair
  • Kate Massey, Executive Director
Websitewww.macpac.gov

MACPAC (the Medicaid and CHIP Payment and Access Commission) is a non-partisan legislative branch agency of the federal government of the United States that provides policy and data analysis, and makes recommendations, to the United States Congress, the Secretary of the U.S. Department of Health and Human Services (HHS), and state governments on issues affecting Medicaid and the Children's Health Insurance Program (CHIP). MACPAC has no regulatory or enforcement authority; its role is advisory, comparable to that of the Medicare Payment Advisory Commission (MedPAC) for the Medicare program. The Commission is headquartered in Washington, D.C.

History

MACPAC was established by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which gave the Comptroller General of the United States — the head of the Government Accountability Office (GAO) — responsibility for appointing the Commission's members. The Commission's statutory charge was subsequently revised, and its funding expanded, by the Patient Protection and Affordable Care Act (ACA) in March 2010.

The first 17 commissioners were appointed in December 2009. The Commission received its first federal appropriation in March 2010, held its organizational meeting that July. Its inaugural public meeting was held in September 2010, and the Commission issued its first Report to Congress in 2011.

MACPAC was explicitly modeled on MedPAC, which Congress created more than a decade earlier under the Balanced Budget Act of 1997 to advise on Medicare payment policy. Policy analysts have noted that Medicaid — a joint federal–state program with substantially more cross-state variation than Medicare — had lacked a comparable independent body dedicated to analyzing its financing and access issues before MACPAC's creation.

Mandate and structure

MACPAC's authorizing statute, codified at Section 1900 of the Social Security Act (42 U.S.C. § 1396), directs the Commission to review and analyze payment policy, eligibility, enrollment and retention, coverage, access to care, and quality of care in Medicaid and CHIP, as well as the interaction of these programs with Medicare and the broader U.S. health care system.

The Commission consists of 17 commissioners appointed by the Comptroller General, drawn from diverse professional backgrounds and regions of the country, including individuals with direct experience as Medicaid or CHIP enrollees, parents, or caregivers, as well as state officials, health plan executives, providers, and researchers. Commissioners serve staggered terms under an annual nomination and appointment cycle administered by GAO. MACPAC holds public meetings several times a year in Washington, D.C., at which commissioners deliberate on and vote on findings and recommendations for transmittal to Congress.

A permanent staff of policy analysts, data analysts, and administrative personnel supports the Commission under an executive director. As of 2026, MACPAC's chair is Verlon Johnson and its vice chair is Robert Duncan; Kate Massey, formerly director of Michigan's Medicaid program, serves as executive director.

Reports to Congress

MACPAC's statute requires it to submit formal Reports to Congress twice each year, by March 15 and June 15. Each report generally comprises several independent chapters on distinct Medicaid or CHIP policy topics and frequently includes recommendations directed at Congress, HHS, or the Centers for Medicare and Medicaid Services (CMS). The recommendations are non-binding, but MACPAC's analyses and deliberations regularly draw independent press coverage and are cited in CMS rulemaking and outside policy research.

Coverage of MACPAC's work has appeared in national health-policy journalism. In April 2023, KFF Health News — republished by USA Today — reported on MACPAC's findings, alongside those of the Government Accountability Office (GAO), that fewer than a quarter of state Medicaid "directed payment" plans running for at least a year had publicly available evaluations, and quoted an outside Medicaid researcher describing the volume of federal inquiries the commission's work had generated on the topic. Modern Healthcare has separately reported in depth on MACPAC's public meetings and commissioner deliberations, including an October 2020 article on the commission's debate over extending postpartum Medicaid coverage that quoted a sitting MACPAC commissioner and detailed the racial disparities in postpartum coverage stability the commission's own data had surfaced. Health policy research organizations such as Georgetown University's Center for Children and Families and the Association of American Medical Colleges also routinely analyze and cite MACPAC's semi-annual reports in their own independent publications.

Beyond its two statutory reports, MACPAC publishes issue briefs, data reports, and comment letters on proposed federal regulations throughout the year, and maintains MACStats, a regularly updated statistical reference on Medicaid and CHIP enrollment, spending, and eligibility.


Policy areas

MACPAC's work has addressed a broad range of Medicaid and CHIP topics, including:

See also

References

  1. 1 2 3 4 "About MACPAC". Medicaid and CHIP Payment and Access Commission. Retrieved 2026-08-07.
  2. 1 2 "Request for Medicaid and CHIP Payment and Access Commission (MACPAC) Nominations". Federal Register. 2025-01-02. Retrieved 2026-08-07.
  3. 1 2 "MACPAC Releases its First Report to Congress on Medicaid and CHIP" (PDF). Medicaid and CHIP Payment and Access Commission. Retrieved 2026-08-07.
  4. ↑ "A MedPAC and MACPAC Primer". Applied Policy. 2025-03-18. Retrieved 2026-08-07.
  5. ↑ "42 U.S.C. § 1396 – Medicaid and CHIP Payment and Access Commission". Office of the Law Revision Counsel, U.S. House of Representatives. Retrieved 2026-08-07.
  6. ↑ "Commission Staff". Medicaid and CHIP Payment and Access Commission. Retrieved 2026-08-07.
  7. ↑ "MACPAC Names Kate Massey as Executive Director". Medicaid and CHIP Payment and Access Commission. Retrieved 2026-08-07.
  8. ↑ Report to Congress on Medicaid and CHIP (PDF) (Report). Medicaid and CHIP Payment and Access Commission. June 2025. Retrieved 2026-08-07.
  9. ↑ Miller, Andy (2023-04-10). "Special Medicaid Funds Help Most States, but Prompt Oversight Concerns". KFF Health News. Retrieved 2026-08-07.
  10. ↑ "MACPAC: Expanded postpartum coverage needed, but resources lacking". Modern Healthcare. 2020-10-30. Retrieved 2026-08-07.
  11. ↑ "Medicaid Managed Care in 2025: The Year That Was". Georgetown University Center for Children and Families. 2025-12-17. Retrieved 2026-08-07.
  12. ↑ "MACPAC Releases March 2025 Report to Congress on Medicaid and CHIP". Association of American Medical Colleges. 2025-03-21. Retrieved 2026-08-07.
  13. ↑ "MACPAC Highlights PACE in Annual Report to Congress on Medicaid and CHIP". National PACE Association. 2025-06-13. Retrieved 2026-08-07.