Moving Forward on CHIP: Congress Should Clear the Way for a Bipartisan Approach
Yesterday was a busy day for the Children’s Health Insurance Program (CHIP). Two key committees held hearings on Wednesday that considered legislation to refund the CHIP program whose funding expired on September 30. The House Energy & Commerce committee marked up the Helping Ensure Access for Little ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable (HEALTHY KIDS) Act while the Senate Finance Committee considered the Keep Kids’ Insurance Dependable and Secure Act of 2017 (KIDS) Act. Early in the day, the Senate Finance Committee passed their CHIP refunding bill through committee by voice vote. Late last night, Energy & Commerce voted to pass their version through committee on partisan lines (28-23) with no support from Democrats.
Doesn’t CHIP Have Bipartisan Support?
CHIP is a longstanding program that enjoys bipartisan support. It important to highlight that the CHIP policy attributes of the House bill largely mirrors the Senate bipartisan agreement. Both bills would:
- extend CHIP for five more years
- preserve the ACA’s 23 percentage point bump for two more years
- continue the law’s “maintenance of effort” requirements that prevented states from reducing eligibility for the program but includes some changes that give states flexibility
Yet, despite the agreed upon policy framework above, the House bill resulted in a partisan vote. As raised during the House hearing on Wednesday, the “offsets”– how congress funds the program – are the point of contention, and with good reason. In the House bill, CHIP is funded by shifting costs onto other groups. In brief, these offsets include:
- repealing special treatment for Medicaid third-party liability that currently protects pregnant women and children from being denied health care.
- instituting premium hikes for higher-income Medicare recipients. This could worsen the Medicare risk pool and degrade universal support for the important program.
- preventing some lottery winners from accessing Medicaid. This could lead to higher administrative costs for states tasked with collecting funds and evidence tells us that the administrative cost would not justify the increased revenue.
To learn more about the offsets, our partners at the Center on Budget and Policy Priorities provide a detailed analysis here.
What is next?
We are beginning to see the impact on states as they grapple with the uncertainty caused by the expiration of federal funds. Minnesota has already run through its CHIP allotment and obtained additional funds to keep the program running through October, while Utah filed an amendment to restrict eligibility and benefits for CHIP enrollees if the state runs out of funds. Other states are struggling not just with state budget planning but also with triggers related to notices—Colorado has created an FAQ to help consumers understand the issue due to confusion about CHIP coverage ending on the cusp of the Marketplace open enrollment.
Decision makers need to hear from consumers. We need swift, urgent action from Congress to refund this important program that serves over 9 million children and pregnant women. Advocates should continue to make calls, share stories and increase pressure on Congress. Congress has agreed – as evidenced by the shared CHIP policy priorities in the House and Senate legislative texts. They should act now to fund CHIP – as they’ve agreed – and return to bipartisan negotiations for a path forward that includes responsible funding sources that advance children’s health without harming others.