Congress must take action before the end of the month to address a number of health care-related issues, including reauthorization of the Children’s Health Insurance Program (CHIP). CHIP, which provides health coverage to 8.9 million children, is set to expire on September 30. Republicans must work with Democrats to enact a comprehensive, long-term reauthorization of this program and prevent a disruption in coverage for millions of our nation’s children. In addition, Congress must also reauthorize funding for critical health care programs, such as community health centers and physician training in rural and underserved areas.
What is CHIP? Who does CHIP cover?
The Children’s Health Insurance Program (CHIP) is a partnership between the federal government and states that has helped ensure access to health care for children and pregnant mothers from low-income working families across the United States. The Affordable Care Act (ACA) strengthened the CHIP program, eliminating barriers to enrollment and providing additional matching funds to states to expand coverage.
CHIP By The Numbers:
- CHIP and Medicaid cover 1/3 of American children [Georgetown Health Policy Institute, 3/13/17]
- CHIP provides affordable, comprehensive health coverage to nearly 9 million children and 4,200 pregnant women. [MACPAC, 5/2017]
- Together, CHIP and the Affordable Care Act are credited with achieving the lowest uninsured rate for children in history, with 95% of children covered. [Georgetown Health Policy Institute, 3/13/17]
- If Congress fails to reauthorize the program, 1.1 million children will lose coverage. [MACPAC, 1/2017]
What happens if CHIP is not reauthorized?
Without reauthorization, states will be unable to maintain the current level of access to health coverage for children in low-income families. If CHIP funding expires after September 30th, all states will exhaust their federal funds by the end of Fiscal Year 2018. Three states and DC will run out of federal funding by the end of 2017. By March 2018, 27 additional states will deplete their federal funds.
According to the Kaiser Family Foundation and Georgetown University Center for Children and Families, “without federal funding, states would face budget pressures, children would lose coverage, and implementation of program changes could result in increased costs and administrative burden for states as well as confusion for families.” [KFF Fact Sheet, 9/6/17]
Who is at risk?
If Congress fails to reauthorize the program, 3.7 million children would lose CHIP coverage. Some of those children will be shifted onto Medicaid or onto the ACA health care exchanges, but 1.1 million children will be at risk of losing coverage altogether, according to MACPAC. States will incur significant costs associated with shifting children off of CHIP and onto other coverage programs. In the case of a lapse in federal funding, states like Arizona have policies that instantly freeze enrollment, leaving more children at risk to lose coverage next year.
Most states assumed CHIP would be reauthorized when passing their state budgets, meaning without this funding by September 30, states will not have enough money to cover children currently enrolled in their state's CHIP program. States also estimate that losing federal funding would mean increased costs for outreach and training. For example, Colorado estimates that losing federal funding would result in $300,000 in increased costs. [KFF Fact Sheet, 9/6/17]
Who supports CHIP?
CHIP is a program that has traditionally received bipartisan support. Republicans in both the House and Senate agree it’s critical that Congress act to reauthorize the program:
Senator Orrin Hatch (R-UT): “If Congress doesn’t act to provide additional federal funding, a number of children who would likely be eligible for CHIP will go uninsured once federal funding is exhausted.” [Kaiser Healthcare, 9/7/17]
Senator Tim Scott (R-SC): “For almost 9 million children across the country, including nearly 80,000 in South Carolina, the CHIP plays a vital role in assuring our young folks are healthy enough to learn and thrive in school and in life.” [Senate Finance Hearing, 9/7/17]
Senator Dean Heller (R-NV): “… [CHIP] is a critical program and one that helps millions of children….In Nevada, CHIP provides medical coverage for roughly 25,000 children who otherwise may not get care. Over the years, this program has been responsible for increasing coverage for low income children…” [Senate Finance Hearing, 9/7/17]
Rep. Greg Walden (R-OR): “We recognize that CHIP and community health centers play a significant role in the Nation’s safety net for millions of Americans, for millions of American children, and pregnant women who are generally low- to moderate-income, and millions of individuals who may be medically underserved or face other barriers to care.” [Energy and Commerce Subcommittee on Health Hearing, 6/23/17]
Rep. Michael Burgess (R-TX): “The State Children's Health Insurance Program provides healthcare coverage to over 8 million children across the Nation through flexibility capped allotments to States. The program has been able to successfully support children while providing States with opportunities to tailor their respective programs as to best meet the needs of their populations.” [Energy and Commerce Subcommittee on Health Hearing, 6/23/17]
What other priorities need to be reauthorized?
In addition to CHIP, a number of health care priorities must also be addressed by September 30, including:
- Community Health Centers, which offer comprehensive primary care in rural or underserved communities.
- Teaching Health Centers, which provide physician training in underserved areas and community-based settings across the United States.
- National Health Service Corps, which provides scholarships and loan repayment assistance to medical students and residents training to become primary care providers in underserved communities.
- Maternal, Infant and Early Childhood Home Visiting Program, which provides nursing visits for new, at-risk mothers.
- Preventing cuts in Medicaid reimbursements to safety net hospitals.
- Puerto Rico’s Medicaid program, which serves children, seniors in nursing homes, and disabled Americans living on the island.
Democrats stand ready to address these health care priorities, so that we can avoid disruption and ensure continuity of care for children and Americans of all ages across the country. It’s time for Republicans to work on a bipartisan basis to provide certainty and stability in the health care system.
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