By Jennifer Perkins
According to a recent survey by the T.H. Chan School of Public Health at Harvard University, renewing funding for the Children’s Health Insurance Program (CHIP) is the public’s top priority for Congress.
Yet here we are, three months past its expiration, with no resolution in sight despite a fresh new year full of promise and hope.
The Continuing Resolution, or stopgap spending bill, lawmakers passed before leaving Washington for the holidays provided $2.85 billion for CHIP and $550 million for community health centers through March 31, but a long-term, bipartisan deal remains elusive.
Democrats and Republicans are divided over how to pay for the program. A five-year extension of CHIP would cost about $80 billion.
The House passed a five-year extension, but Democrats objected to using funds from the Affordable Care Act’s (ACA’s) prevention and public health fund, and reducing Medicare benefits for lottery winners and wealthy enrollees.
A bill that cleared the Senate Finance Committee in November did not detail how the program would be funded and was never taken up by the full chamber.
Since 1997, when CHIP was enacted with bipartisan support, it has provided critical health care services to children in working families who earn too much to qualify for Medicaid but too little to afford private health insurance. In fact, CHIP has helped cut the number of low-income, uninsured children across the country by 80 percent, dramatically increasing access to health care. Figures from the Texas Health and Human Services Commission show that CHIP covers more than 400,000 children here.
CHIP provides states with significant design flexibility to meet the specific needs of their child populations. And because CHIP is a program built specifically for children, its benefit design — which emphasizes receiving medical services in a primary care setting — and its robust provider network meet children’s unique needs. CHIP is particularly successful in accommodating children with special health care needs.
Research by the Government Accountability Office shows that CHIP coverage has more comprehensive benefits and is more affordable than either marketplace or employer-sponsored coverage. Congress simply must continue federal funding of CHIP at the enhanced matching rate in effect for each state as of Sept. 30, 2017, in accordance with the 2018-19 General Appropriations Act. In Texas, that enhanced matching rate is 93 percent.
Loss of CHIP coverage would mean almost 400,000 vulnerable Texas children would be forced into the expensive, unstable individual marketplace, likely resulting in much worse access to health care. After the natural disasters that recently ravaged Texas, including Hurricane Harvey, disrupting or eliminating coverage for children could be disastrous to their health.
Texas’ fiscal health would suffer as well. Returning CHIP to its previous match rate of 69 percent, its funding level before the ACA expanded it, would result in the loss of several billion dollars of federal funding at a time when we can scant afford the reductions and would not have time to plan. Eliminating CHIP altogether would mean billions in additional expense — tremendous unaffordable costs — and drastic cuts that children do not deserve.
Simply put, not extending CHIP would place an untenable burden on Texas’ budget and residents at a time when Texas added more residents than any other state in the previous year. With an end-of-March deadline looming, letters informing families of cuts would need to be sent in February. Texas children deserve a much better Valentine than that.