WASHINGTON — The Children’s Health Insurance Program (CHIP), a popular government benefit supported by Democrats and Republicans alike, is seen by many analysts as a cost-effective way to provide health coverage for children whose parents cannot afford private insurance.
But CHIP’s federal funding is in limbo because the program is getting tied in with larger political debates in Congress pertaining to immigration policy. Even with the threat of a possible government shutdown looming, lawmakers on both sides of the aisle were still unable to reach an agreement on funding CHIP as of Jan. 18.
“This could be a quick, easy victory for Congress, where they could come together in a bipartisan way and do something that’s great for kids. It’s not really that heavy a lift, but they just haven’t been able to get it done,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families.
Alker told the Register that the lack of a congressional agreement has been “frustrating,” adding that families who rely on CHIP for their children’s health care have been worrying for months that the money will soon run out for their insurance coverage.
“There’s really no excuse for it, since they’ve had a bipartisan agreement on this for quite some time now,” Alker said.
The program ran out of federal funding in October. Congress subsequently passed a $2.85-billion stopgap spending bill intended to keep CHIP running through March, but various estimates indicate that some states could start running out of money by late January.
Georgetown’s Center for Children and Families estimates that 1.7 million children in separate CHIP programs in 21 states could lose their coverage by the end of February. Beginning just before Christmas, families in several states began receiving letters warning them of the program’s possible termination.
“We would expect that most of these children would become uninsured,” said Alker, adding that some of those families could find insurance on the Affordable Care Act’s exchanges, though the coverage there, she said, does not offer the same comprehensive pediatrics coverage as CHIP.
Said Alker, “Either the children would be uninsured or they would have worse coverage. Those are basically the two outcomes, and neither of those are good outcomes.”
Sister Carol Keehan, the president and chief executive officer of the Catholic Health Association of the United States, told the Register that lawmakers are using the program as a bargaining chip in congressional budget negotiations to keep the federal government running.
“There is no excuse for this,” Sister Carol said. “To keep people up in the air, to have people going off insurance rolls, while we play games using it as a bargain chip, is just not responsible, and it’s not moral.”
According to published reports, House Republicans were trying to avert a shutdown through a stopgap bill to fund the federal government through mid-February, but that measure did not meet Democrats’ demands for protections for young people who were brought to the United States illegally as children.
Several Democrats have insisted that their immigration demands be included in any temporary spending bill. Lawmakers on both sides have been accusing each other of brinkmanship and unnecessarily risking a shutdown when the federal government runs out of money Jan. 19.
“In the end, rightly or wrongly, the Democrats believe that DACA is a winning issue,” said Robert Destro, director of the Institute for Policy Research and Catholic Studies at The Catholic University of America. Destro was referring to “Deferred Action for Childhood Arrivals,” a policy crafted by President Barack Obama that would avoid deporting people who were brought to the United States illegally as children.
Destro also told the Register that he believes complicating congressional negotiations is that the Republicans are more fractured while Democrats are “consistent” on issues like health care and immigration.
Said Destro, “When you look at the Republicans, they’re at odds with each other on the basics, so it’s harder for them because they have to negotiate within their own party as well as against a very organized and disciplined opposition.”
Destro added: “But at the same time, for the Democrats, how much are they willing to hold everything else hostage to DACA? In the end, you have to figure out which problems you’re going to solve in what order.”
House Bill Stalled
Last November, the House of Representatives passed a bill to extend CHIP funding for five years, but Democrats balked at the measure because its $8-billion price tag was paid for with cuts to the Affordable Care Act and Medicaid. The Senate never took up the bill.
Georgetown’s Alker said CHIP funding was also sidetracked by the debates over repealing the Affordable Care Act’s individual mandate, which the Republican-led Congress accomplished in its tax-reform bill in December.
“I think this speaks to the dysfunction that we’re seeing in Congress because CHIP is a popular program and a successful program,” Alker said.
On Jan. 11, the Congressional Budget Office reported that if Congress were to extend CHIP for 10 years, the federal government would save money because the alternatives to providing health coverage through Medicaid, subsidized coverage in the marketplaces and employer-based insurance are all more expensive.
CHIP, a block grant program where each state receives an allotment based on projected expenditures, serves nearly 9 million children every year. A Henry J. Kaiser Family Foundation public opinion poll in November found that 46% of Americans believe reauthorizing CHIP should be a top legislative priority.
U.S. Bishops’ Perspective
In a letter he sent to individual lawmakers in October, Bishop Frank Dewane of Venice, Florida, in his capacity as chairman of the U.S. Conference of Catholic Bishops’ Committee on Domestic Justice and Human Development, said reauthorizing CHIP is “essential for the good of our nation’s children.”
Said Bishop Dewane: “CHIP has been a reliable source of coverage for low‐income children in working families whose parents earn too much to qualify for Medicaid but too little to afford private health insurance.”
Sister Carol of the Catholic Health Association said many children rely on CHIP for treatment for chronic diseases like diabetes or serious health problems such as cancer. She believes CHIP will ultimately be reauthorized, though she chided lawmakers for being thoughtless in putting families through a stressful situation.
“This is not the American way,” Sister Carol said. “These legislators are elected to make sure that the people who elected them are well-served, and they are not doing that.”
Register correspondent Brian Fraga writes from Massachusetts.