Will Congress Get Around to Reinstating the Children’s Health Insurance Program?

As Congress returns after Thanksgiving, members face a complicated calendar.  They must pass a budget bill by December 8 (or another continuing resolution and an eventual budget by year’s end) to keep the government from shutting down, deal with tax reform that is a priority of the President and the Republican Congress, and deal with another try at changing the Affordable Care Act—something that has now been tucked into tax reform.

And then there are some smaller things, including reinstating the Children’s Health Insurance Program that Congress allowed to lapse on September 30.  What kind of society puts tax cuts for corporations and the wealthy ahead of medical care for its poorest children?

The Children’s Health Insurance Program (CHIP) was always a bipartisan effort—originally sponsored by Orin Hatch, a Utah Republican and Ted Kennedy, a Massachusetts Democrat.  CHIP is a program for the children of the working poor;  it covers 9 million children whose families earn too much to qualify for Medicaid but too little to afford private insurance. The program also covers low income women who are pregnant. And Mark Trahant, writing for OurFuture.org, explains that 54 percent of American and Alaska Native children rely on Medicaid or CHIP to pay for their healthcare.

NBC News explains: “CHIP is funded by a combination of state and federal dollars.  An estimated 11 states will run out of federal CHIP funding by the end of the year, according to a study by the Kaiser Family Foundation, a nonpartisan research organization, and 21 more states… will be depleted by March 2018.”

Annie Lowrey, in The Atlantic, describes the dilemma being faced by the state officials who administer the program: “The 50 states, according to the intricacies of 50 budgets and the laws and policies governing their 50 CHIP programs, are figuring out what to do.  That means figuring out how much money they have and how long they can extend coverage.  It means figuring out whether they need to cap enrollment or let a program lapse.  ‘It’s not just trying to pinpoint the exact date’ a state will run out of money, Jesse Cross-Call, a senior policy analyst at the Center on Budget and Policy Priorities… told me.  ‘It’s also executing whatever process is supposed to happen by statute or by whatever dictates the policy change at the state level. The process of putting together notices—states haven’t had to do that before. It’s not like they can call up that Word document from two years ago and change the date on it.’  It means figuring out how to enact a cap, freeze, or shutdown—something many states have never done.”

Writing for the Washington Post, Colby Itkowitz and Sandhya Somashekar describe how the federal agency that works with state governments is trying to inform state partners: “The Centers for Medicare and Medicaid Services (CMS), which administers the program at the federal level, issued a notice to state health officials on Nov. 9 detailing their options if CHIP funding does run dry.  States forced to end the program will need to determine whether enrolled children are eligible for Medicaid or whether their family will need to seek insurance through an Affordable Care Act marketplace, the guidance said… The program, which is credited with helping to bring the rate of uninsured children to a record low of 4.5 percent, has been reauthorized several times over the years. And under the ACA, the federal government sharply boosted its match rate. It now provides 88 percent or more of every state’s CHIP costs. Congress has been unable to agree on how to pay for the $15 billion program moving forward, however.  President Trump’s 2018 budget proposed to cut billions from CHIP over two years and limit eligibility for federal matching funds.”

The U.S. House of Representatives has passed a bill to reauthorize CHIP, but it takes money from other federal health programs to pay for reinstating CHIP—including cuts to Medicare and Medicaid. Mark Trahant explains more about the bill the House has passed: “(T)hat bill included a $6.35 billion budget cut to other health programs, including the Prevention and Public Health Fund, which provides money for vaccines, smoking cessation, and other initiatives to improve public health. The House would also ban lottery winners from being insured by Medicaid, tighten the timetable for people to sign up, and change other rules.”  A Senate committee is considering another version.

Perhaps, some predict, a bipartisan compromise on CHIP will be part of whatever final budget agreement Congress must reach to keep the government running. But, if Congress is distracted what are seen as the bigger problems—passing some kind of budget—achieving promised tax reform for corporations and the wealthy, the needs of low-income families and children may again be pushed aside. One even worries that our society may have come to consider the children of the poor to be undeserving.

So, what does all this have to do with an education blog? Make no mistake, programs like CHIP and the Affordable Care Act make an enormous difference for public schools. Poverty is recognized increasingly as the variable most closely tied with academic achievement. Prenatal care and access to pediatric care directly impact children’s capacity to thrive and focus on school. Tax reform and avoidance of federal deficits must never trump the well-being of our nation’s children.