Health Policy$ense

While politicians squabble over CHIP reauthorization 9 million kids are at risk

October 16, 2017 [cross-posted from the Health Cents blog on]

Nine million. That is the number of children whose health insurance is in jeopardy because Congress has not met its Sept. 30 deadline for reauthorizing the Children’s Health Insurance Program (CHIP).

CHIP provides health insurance for children whose families earn too much to qualify for Medicaid insurance but cannot afford private insurance. Having health insurance allows kids to lead healthier, more productive lives. Take for example, my patients, the Thompson family (the name has been changed to protect their privacy). Ms. Thompson is a hard-working single mother who supports her family of five by working in food services at a local hospital. Through CHIP, the youngest Thompson child –  Gabby, 7 – was able to get much needed eye surgery with a copay her mother could afford. Eighteen year-old James was able to get the vaccines he needs before he goes off to college, and fifteen year-old Evan could see a sports medicine doctor for a knee injury that was keeping him off the soccer field.

And it’s not just the Thompson family. Of the nine million, CHIP provides health insurance for 175,000 children here in Pennsylvania. Thanks in large part to CHIP and Medicaid, the percentage of children in the US with health insurance has reached an all-time high of 95 percent.

Unlike many issues in politics, CHIP had bipartisan support when legislators introduced it twenty years ago, and still has bipartisan support today. However, due to the way it was set up, every few years Congress must vote to extend funding for the program. It is unprecedented that we are past the budget deadline without CHIP reauthorization secured.

Last week, the Senate Finance Committee did pass a bipartisan bill to reauthorize CHIP and it is likely this support from both sides of the aisle will continue as it goes to a full Senate vote. However, though the House Energy and Commerce Committee also just passed a reauthorization bill, it included provisions on CHIP financing that resulted in voting on party lines. Without bipartisan support, it is expected that the House will have prolonged debates on its bill and CHIP reauthorization will be even further delayed.

I worry what will happen to the Thompson family and others like them if the delay in CHIP reauthorization continues. Recent estimates by the Medicaid and CHIP Payment and Access Commission (MACPAC), a non-partisan government agency that analyzes CHIP and Medicaid, suggest that if not reauthorized, Pennsylvania will exhaust all federal CHIP funding by February 2018. That means the Thompsons will receive a letter in the mail telling them that the insurance they have relied on is no longer an option. Ms. Thompson will then have to make the difficult choice between paying for what will likely be more expensive insurance or leaving her children uninsured. This matters because children with CHIP health insurance have better access to primary and specialty care and miss fewer days of school than children without insurance.

Congress must set aside partisan politics and take swift action to protect the millions of children who rely on CHIP. Families like the Thompsons are counting on them.