It's Been 100 Days. Why Is Congress Still Denying Children Their Health Care?

01_09_18_CHIP_funding
In Focus

Why Hasn't Congress Funded CHIP Yet?

It's been 100 days since Republicans and Democrats let critical CHIP funding expire.
Launch Slideshow 2 PHOTOS

One hundred days have passed since Congress allowed funding for the Children’s Health Insurance Program (CHIP) to lapse.

Over the last 100 days, Congress has ignored one of its most successful creations. CHIP fills an important gap by providing health coverage to low-income children whose families typically earn too much to qualify for Medicaid, but not enough to buy coverage for themselves or their kids. Its origins are bipartisan. And it is a major success story, having cut the number of uninsured children in America by two-thirds since its enactment in 1997.

Over the past 100 days, states have had to scramble to keep their own children’s health insurance programs afloat. Unlike Medicaid, CHIP is not an entitlement program. Children are not guaranteed coverage unless the federal government specifically allocates funding through block grants to the states, which have great leeway in administering the program. Many states require parents to pay premiums and to share costs through copayments and deductibles.

Over the last 100 days, inaction by Congress has forced some states to tap into emergency funds. More than half of all states are expected to exhaust their funding in the next six months.

Over the last 100 days, millions of parents have had to worry about the future of their children’s health care. In 2016, CHIP covered more than 8.9 million children. Their health coverage is now at risk.

Over the last 100 days, the federal government has been in a partisan political stalemate, stringing along the families who rely on CHIP for their kids’ coverage with a series of short-term stopgap funding measures. This is a lamentable and avoidable case of poor governance.

01_09_18_CHIP_protest1 University of Chicago medical students call on Congress to reauthorize funding for CHIP. Getty

CHIP, by all rights, should be completely uncontroversial. On Friday, the Congressional Budget Office estimated that extending CHIP would add about $800 million to the federal debt over the next 10 years—a very low net cost for a program that serves nearly 9 million kids. And who in Congress, Republican or Democrat, really wants to come out against health coverage for kids?

While stopgap funding resolutions prevent the program from shutting down wholesale, they are already doing damage. Some states, like Colorado and Virginia, are already sending out notices telling families to prepare for the possibility that the program will shutter, which may lead families to withdraw from the program and forego needed treatment if this uncertainty persists.

The 100-day lapse in CHIP funding points to a larger issue. This stalemate has exposed the weakness of block-granting safety net programs—the grants themselves are subject to the whims of legislators in a given year.

Congress has managed to miss a deadline that was known for months in advance, and is now overdue by 100 days and counting. Kids’ health coverage—and for some, their health—are at stake. If Congress can’t do the block grants for CHIP right, why should we trust them to fund block grants for other safety net programs?

Unless Congress acts soon, states will be forced to curtail enrollment and health services for children. Some kids will lose coverage and forego primary and preventive care. They will lose access to specialist and dental care. And their mothers will lose access to prenatal checkups and other health services for their unborn child.

There’s no good reason for children in need to be denied access to health coverage. Protecting CHIP will provide the kind of fiscal stability that states need, and the health security that families deserve. Congress needs to fund CHIP—now.

One hundred days is long enough.

Margaret A. Murray is chief executive officer of the Association for Community Affiliated Plans (ACAP), a trade association of 61 not-for-profit Safety Net Health Plans. Most ACAP-member health plans provide managed care services for state CHIP programs.

Editor's Pick