October 27, 2017
Area(s) of Interest: Access to Care Advocacy
Federal funding for the Children’s Health Insurance Program (CHIP) expired on September 30, 2017. Although the successful 20-year-old program has historically had bipartisan support, Congress was consumed by efforts to repeal and replace the Affordable Care Act (ACA) and missed the deadline to extend the program and its funding without interruption.
Both the House and Senate passed bills out of committee in early October that would extend CHIP funding for five years at the enhanced ACA CHIP matching rate, but only through 2019. The bills also include an extension of the express lane eligibility and outreach programs. Yet neither proposal has been brought up for a floor vote because Republicans and Democrats can’t agree on the funding.
Originally, Republicans proposed to fund it by cutting the ACA public health fund and raising Medicare out-of-pocket costs for higher income seniors. With Congress now set to debate tax reform, CHIP reauthorization is likely to be delayed until the end of the year and included in the omnibus bill to keep the government running. In the meantime, funding negotiations will continue. Over the past 20 years, CHIP has helped reduce the nation’s uninsured rate for children to a record low of 5 percent. In California, the CHIP program currently serves nearly 2 million children and pregnant women – more than 9 million nationwide.
Since its inception, CHIP has successfully provided children of low-income, working families access to physicians so they have a chance to grow up healthy and thrive. It provides access to comprehensive coverage, mental health services and essential preventive services, such as immunizations and developmental screenings, to prevent more serious illnesses and disease.
Although the federal funding has officially expired, states can still use remaining money from their 2017 CHIP allotments to keep their programs operational. Eleven states have reported that they will exhaust their federal CHIP funding by the end of 2017, with 32 projected to run out by March 2018. The Centers for Medicare and Medicaid (CMS) has stepped in to help a few states that have exhausted their funding, but CMS stopgaps won’t cover all 50 states.
California is one of five states that have already received emergency funding from Medicaid to keep their programs running. It is unclear, however, how long that funding will last. Without the emergency funding, California’s CHIP program would have run out of money well before the end of the year.
The California Medical Association (CMA) continues to pressure Congress to act quickly to renew this critical, cost-effective program. CMA has urged Congress to reauthorize the program for at least five years at current funding levels to give states the stability to engage in long-term planning and innovation.