Everybody Loves CHIP, So Why Isn’t It Permanently Funded?

Washington-Pediatrician Dr. Kim Schlier (D-Wash.) She was asked about important medical provisions for the Build Back Better Act at the Family USA Virtual Conference in January. There was one item I checked. Mention: Permanent funding for the Children’s Health Insurance Program (CHIP).

“Every year, the Children’s Health Insurance Program was used as a bargaining tool, which is very unfair to children and families and is meant to pawn them in these discussions,” Schlier said. I am saying. “With CHIP’s permanent funding and approval, we can sigh relief for all families who depend on CHIP’s coverage.”

Created in 1997, CHIP serves families who are low-income but make a lot of money to qualify for Medicaid. It is funded by both the federal government (in the form of block grants) and matching grants from the state, and currently serves approximately 7 million children nationwide. However, funding CHIP is not a permanent part of the federal budget, so Congress will need to reapprove the funding every few years.

Currently licensed by 2027

CHIP funding is currently approved until September 30, 2027, but many child care advocates want permanent funding approval. And while the provisions for doing just that are contained in the Buildback Better Act passed by the House of Representatives, the future of the law in the Senate is believed to be volatile.

“Suppose you have a child with asthma and you are covered by CHIP and its funding. [is] Pam Shaw, MD, a pediatrician in Kansas City, Kansas, said: Chairman of the Government Affairs Committee of the American Academy of Pediatrics, [kids are] You will be able to take care of it, and also ensure that children with chronic illnesses are covered specifically without gaps. “

Normally, CHIP’s funds are renewed without any problems, but in 2017, Congress failed to reapprove the program by September 30, the end of the fiscal year, creating a gap in funds of several months. .. Ann Dwyer, JD, and MPH, Associate Research Professors at the Center for Children and Families at Georgetown University, said:

“At that time, a bill was passed in 2017 calling for a six-year extension, but it didn’t cross the finish line by the end of the fiscal year,” she said in a telephone interview. “Therefore, there was a period of funding uncertainty in 2017, with more heartburn for the state and obviously more heartburn for the family. Eventually, Congress could enact an extension of funding. I was able to do it. “-First, it was a 6-year extension of funding, and finally a 10-year extension.

“Really scary for many”

In a telephone interview, Shaw said the lack of funding in 2017 was “really scary for many.” “Then you have a language barrier and they don’t understand why their insurance no longer covers them … many of these people have jobs, but they do in their jobs. You may not be able to afford the family compensation offered. For them, this is a great lifeline to make sure their children are always covered. “

During the funding gap, “many states had to start notifying their families to let them know that the state no longer had enough money to run its program.” Benjamin, director of health and economic mobility policy for the Children’s Defense Fund, explained, advocacy group. “We were somewhat fortunate that the state was in a financial position with sufficient reserves to keep things going, but Connecticut frozen registration for the program for a short period before Congress funded it. I think I had to. “

Taking such measures is “destructive to state governments that require budget clarification, and it is very destructive and confusing for children and families. Many of them have their health insurance. Received an email notification that may not be there, and the family wasn’t’don’t know-‘can I re-register for this coverage? Need to find coverage elsewhere?’ So I don’t know how many families were confused, or how many children didn’t re-register for coverage because of a bureaucratic nightmare, or missed a doctor’s appointment. “

Why is there nothing yet?

CHIP is considered very successful and is known to have support from both Republicans and Democrats. So why isn’t it permanently funded? Dwyer seems to disagree with the idea of ​​making CHIP funding permanent, but agrees that “it is just a means, a political will.” Of the two independent bills in the House to make that happen, one is sponsored by Republican Vern Buchanan, Florida, and the other is Nanette Barragan (D-California).

According to Anderson, CHIP currently costs the federal government about $ 17 billion annually, and while deciding where to raise money for the bill is often a problem, the Parliamentary Budget Department will permanently fund CHIP. I have found that doing so can actually save government money.

“The main driver is the cost of covering children. [Affordable Care Act] The market as an alternative, “he said. “If the money expires, some children will be transferred to market coverage and federal costs are expected to increase.”

On the other hand, if the funds are permanent, the move will not have to happen.

Those who support making CHIP funding permanent have said they hope it will, although it may not occur with the bill currently being offered. “If we see any action on funding this year, I expect it to have to be done in the budget adjustment process,” Anderson said. “I just haven’t seen Congress pick up a standalone CHIP extension bill, which is usually not seen until the deadline is approaching.”