Last Saturday, September 30, Congress let the Children’s Health Insurance Program lapse. When the program was reauthorized in 2015, Congress set September 30, 2017 as the deadline for renewal. If Congress can get its act together, it can still vote to renew the program. But the longer Congress waits, administrative and fiscal problems will grow for the states who are partners in this effort, and medical problems will loom for children when coverage is threatened.
There is widespread concern that failure to renew CHIP on time is a symptom of Congressional disfunction. On September 18, Senators Orin Hatch (R-Utah) and Ron Wyden (D-Oregon) introduced a bipartisan bill to reauthorize CHIP, but momentum collapsed in the Senate during the late-September debate over the Graham-Cassidy bill to overturn the Affordable Care Act.
Writing for the New Republic, Clio Chang quotes Bruce Leslie, president of the children’s advocacy group First Focus: “There was growing attention and movement towards getting this done and then Graham-Cassidy came up and everyone stopped talking to us about it. It was hard to get meetings after that, to talk to people about the Hatch-Wyden bill. People were like, ‘No we’re 24/7 on Graham-Cassidy’… It just dumbfounds me that they’re not doing this… It’s a no-brainer.”
In her Washington Post column, Valerie Strauss explains that the failure to renew children’s healthcare legislation cannot be without consequences for the nation’s public schools. CHIP is a health insurance program for children in poor and moderate-income families: “If action is not taken soon to restore the funding, the effects will become obvious in schools across the country, with many of the children in the program unable to see a doctor for routine checkups, immunizations, visits when sick and other services.” According to Strauss, the program cost to the federal government in 2016 was $13.6 billion.
CHIP currently covers 9 million children. Writing for Roll Call, Rebecca Adams explains: “CHIP was instrumental in boosting the share of children nationwide who have coverage from 86 percent in 1997, the year Congress enacted it, to 95 percent of U.S. children today.”
CHIP is a federal-state partnership with funding provided by the federal government (and enhanced in some states through their own budgets) and the states administering the program. Adams explains that the impact of Congressional failure to renew the law on time will affect states differently depending on whether they have any program money left unspent: “States can use two-thirds of any leftover money until it’s gone, leading some lawmakers to suggest that the deadline is not a hard one.” Minnesota will be the first state to run out of money: “The state would likely be out of money for coverage of low-income children and pregnant women by the end of September… Minnesota is the first state to hit a funding crisis, but others are on the cusp. Nine other states are projected to face a shortfall by the end of the year… By late March, 32 states would likely drain their money.”
Adams continues: “There are complicated consequences if the funding deadline lapses. If Congress were to take longer than a couple of weeks beyond the deadline to renew the program, some states plan to take steps toward capping enrollment or shutting off coverage entirely… Every state would also face the hassle and costs of preparing for changes and training their staffs… Most states do have budget cushions that would protect their programs for at least another month or two… And parts of CHIP would halt completely Sept. 30. For instance, states would lose the ability to expedite enrollments or the renewal of a child’s benefits in CHIP by using information from other programs such as State Temporary Assistance for Needy Families, Medicaid, or the food stamp benefits…. That so-called ‘express lane’ process has helped kids get covered without delays.”
The failure to renew CHIP is puzzling because there seems to be widespread bipartisan support for the program. Adams wrote her Roll Call piece on September 25, days before the deadline. Describing comments from Congressional representatives and their staffs to explain lack of attention to the CHIP deadline, Adams reports that most everyone said Congress was distracted by the debate about the health care exchanges in the Graham-Cassidy bill: “(T)he health care law exchanges get far more attention. Lawmakers blame this year’s chaotic legislative fights over the law as the primary reason they have been distracted from passing routine, bipartisan updates to existing health care programs that are expiring and must be renewed in order to function… Federal lawmakers say they are doing their best in a year fraught with tensions over the direction of the country, an ambitious agenda, an unpredictable electorate and a nascent presidency that Republicans want to use to reshape the federal government’s role in Americans’ lives.”
It is a tragedy that healthcare for the nation’s most vulnerable children fell by the way. Please let your Senators and your Representative know that you want the Children’s Health Insurance Program renewed as soon as possible. Here is a link to the Action Alert provided by the Network for Public Education.