Time is Running out for the Children's Health Insurance Program

by Samantha Beasley, Health Care Policy Manager, L.A. Area Chamber

The Children’s Health Insurance Program (CHIP) was passed into law in 1997 in order to provide health coverage to children (and pregnant women in some states) who belonged to families that didn’t qualify for Medicaid but couldn’t afford to pay for private coverage. After the Children’s Health Insurance Program Reauthorization Act (CHIPRA) was signed in 2009 by President Obama, health coverage for children was revitalized through increased state funding and additional programmatic options. The Affordable Care Act (ACA) then enhanced federal funding of CHIP by 23 percentage points, provided an additional $40 billion to promote Medicaid and CHIP enrollment, and authorized the program until 2019. Funding for CHIP however, runs out this year, and uncertainty about the future of this program has grown with the new leadership in the 114^th Congress.

One of CHIPRA’s primary goals was to devise strategies to efficiently and effectively get more children enrolled in Medicaid and CHIP. Overall, between CHIP’s original enactment in 1997 and 2012, the percentage of children in the U.S. without health insurance coverage was cut by more than half, from 13.9% to only 6.6%. In addition, the number of children enrolled in CHIP skyrocketed from 660,351 children in 1998 to more than 8.1 million in 2012.

CHIP has traditionally rendered bipartisan support, as many of those in Congress view children’s health as a fundamentally crucial factor in life success and happiness. However, with the enactment of the ACA, many policymakers are questioning the necessity of the program.

CHIP has already been brought to the attention of Congress in 2015 by the top Republican leader of the National Governors Association, Gov. Gary Herbert (R-Utah). At the annual “State of the States” address Gov. Herbert pleaded for Congress to extend funding for the program stating that there would be huge gaps in coverage for children across the country if the plan were allowed to expire. The over 8 million children that CHIP serves will lose their specific care and services under CHIP, and nearly 2 million children will lose health coverage altogether. This only adds to the growing realization by legislators, like Gov. Herbert, that they need to know immediately whether the plan will end in order to make plans for the future.

The Medicaid and CHIP Payment and Access Commission has advised Congress to grant a limited reauthorization of CHIP for two years, giving them time to reassess the funding affordability and adequacy of children’s coverage; and policymakers have been active over the past several years in drafting legislation to reauthorize the program. Last session, for instance, Senator Jay Rockefeller and Representatives Henry Waxman and Frank Pallone, Jr. introduced CHIP extension and improvement legislation, hoping to avoid a disruption in children’s health coverage while giving states enough time to make budgetary decisions.

A year is not a long time in Congress, and policymakers are smart to address this important issue now.