Yes, Funding Has Expired for the Children’s Health Insurance Program— But We Can Still Save Coverage for the 9 Million Kids Who Depend on It.

Updated Oct. 2, 1:30 pm: The KIDS Act of 2017 (described in my original post below) is scheduled for markup by the Senate Finance Committee this Wednesday, October 4, at 9:30 a.m. It’s still important to make those calls to your Senators to make sure they act swiftly to restore funding to this critical program, and while you’re at it, tell them to make sure they preserve the enhanced funding authorized by the Affordable Care Act!

Original post Oct. 2, 11:54 am:

That magic date we’d been hearing so much about, September 30, came and went without Republicans passing a bill to repeal the Affordable Care Act.  There was much rejoicing among Democrats, activists, and advocates. Now if Republicans want to vote on a bill as devastating as Graham-Cassidy was, they’ll be facing a Democratic filibuster, which they’ll need 60 votes to overcome.

But as I explained in a previous post, September 30 was an important benchmark for another reason—it was the day that funding for the Children’s Health Insurance Program (CHIP) was set to expire. And expire it did, leaving the families of the nine million children enrolled in CHIP uncertain of how much longer their coverage will continue.

Half of all states will exhaust their funds by March 2018, with about 10 states running out of money by December 2017. Some of these states, because of the notice requirements of their particular programs, have started notifying families that their children’s coverage is in jeopardy. And not every state has funds to carry forward.

When the news began making its way around the Twittersphere on Sunday morning, some people said that nine million children had just lost their health insurance. For the benefit of the families of those nine million children, as well as the doctors and other healthcare professionals who provide their care, it’s important to be completely accurate: Nine million children have not lost their health insurance, at least not yet. CHIP is still an active federal program, children are still covered, and Congress can still authorize funding for the current fiscal year and beyond.

Nevertheless, lawmakers must move quickly. The expiration of funding is already causing uncertainty and it will soon cause chaos if Congress waits much longer to renew. With budget reform now taking the place of Graham-Cassidy as the main focal point in the Senate, it will be up to us to make clear to our representatives that CHIP must be their top priority.

Children covered by CHIP before funding expired are still covered—for the time being.

Together, CHIP and Medicaid form a critical healthcare safety net for children. Children whose families’ incomes are a bit too high for them to qualify for Medicaid but not high enough to allow them to purchase private insurance benefit significantly from CHIP, as do children with complex medical needs who require treatments, services and equipment that isn’t fully covered by most private insurance.

Like Medicaid, CHIP is a federally funded program that is run at the state level, so program details differ from state to state. According to a report by the Kaiser Family Foundation, many states will be able to continue operating their CHIP programs beyond September 30, using unspent funds from the prior fiscal year, which program rules allow them to carry forward. In most states, therefore, children who were enrolled in CHIP as of September 30 are still covered right now, though how much longer that will last depends on the state.

Half of all states will exhaust their funds by March 2018, with about 10 states running out of money by December 2017. Some of these states, because of the notice requirements of their particular programs, have started notifying families that their children’s coverage is in jeopardy. And not every state has funds to carry forward. The Commissioner of Human Services for Minnesota, Emily Piper, warned that state’s Congressional delegation in a September 13 letter that Minnesota would exhaust its CHIP funds by September 30. She said that her department would have to take “extraordinary measures” to continue coverage beyond October 1 if funding was not renewed in a timely manner.

Lawmakers knew this was coming, and there’s already been a bill introduced to address it.

On September 7, the Senate Finance Committee held a hearing to discuss CHIP funding, which ultimately resulted in Senators Orrin Hatch (R-Utah) and Ron Wyden (D-Oregon) introducing a bipartisan bill on September 18 to extend funding for CHIP for five years. The five-year renewal is consistent with the recommendations of the Medicaid and CHIP Payment Access Commission (MACPAC), a nonpartisan Congressional advisory board. (It’s worth noting that Senator Hatch co-founded CHIP with Senator Ted Kennedy, Democrat of Massachusetts, in 1997.)

The Hatch-Wyden bill, officially known as the Keep Kids’ Insurance Dependable and Secure Act of 2017, or KIDS Act, was reportedly gaining bipartisan support in the Senate going into the end of September. Then the focus shifted to Graham-Cassidy and CHIP fell by the wayside. Advocates and activists fighting for CHIP found their voices drowned out by yet another battle over ACA repeal. Bruce Lesley, president of the child advocacy group First Focus, told L.A. Times columnist Michael Hiltzik that once Graham-Cassidy appeared, “We couldn’t even get a meeting. No one was even taking our calls.”

Most states were assuming that not only would CHIP funding be renewed, but also that the enhanced funding authorized under the ACA would continue in the current fiscal year, something that was recommended by MACPAC. Under the KIDS Act that would be the case for this year. Unfortunately, the bill then gradually phases out the enhancement, a compromise between the MACPAC recommendation and the Trump Administration budget, which eliminated the enhancement immediately. Still, given the alternative, pragmatism seems to demand that the bill be passed as quickly and with as little haggling as possible.

Guess what time it is now? That’s right, it’s time to call your representatives—again.

I know the last thing you want to hear is that you need to pick up the phone one more time to remind the people who represent you to do their jobs. And we all know it won’t be the last time either.

But let’s remember that there were many on both sides of the aisle in Congress who saw the importance of renewing CHIP, but they let funding expire anyway. Lawmakers were distracted by Graham-Cassidy, just like they’re distracted by tax reform now.  Senator Hatch himself has called ensuring healthcare access for children a “moral responsibility.” We need to make sure that responsibility is met.

Whether you live in a red state or a blue one, it’s time to fight again. Call and tell your Senators that the KIDS Act must be brought to the floor for a vote.

And make sure you spread the word! This issue stayed under the radar way too long. Share this post to make sure it doesn’t happen again.

Have questions or comments about this post? Share them below and start a conversation!


Photo credit: © Can Stock Photo / ccaetano

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