Marbell Castillo holds her granddaughter Maia Powell during the toddler's recent checkup at Burke Pediatrics in Fairfax County, Virginia. Maia is covered through the Children's Health Insurance Program. Matt McClain The Washington Post
Marbell Castillo holds her granddaughter Maia Powell during the toddler's recent checkup at Burke Pediatrics in Fairfax County, Virginia. Maia is covered through the Children's Health Insurance Program. Matt McClain The Washington Post

Politics & Government

Funding impasse puts health coverage at risk for millions of children

By Tony Pugh And Emma Dumain

tpugh@mcclatchydc.com

December 20, 2017 01:01 PM

WASHINGTON

With prospects for a long-term reauthorization of the Children’s Health Insurance Program this year rapidly dimming, 25 states are expected to exhaust their federal funding to provide coverage for 1.9 million low-income children by January 31, researchers at Georgetown University reported.

Key Republican senators said Wednesday that the CHIP program’s longer term future would be decided next year. Instead, Republicans Thursday offered a plan to keep the program funded only through early next year.

Congress must pass a government spending bill by Friday night, or trigger a partial shutdown of federal operations. CHIP advocates had hoped the program, whose funding authorization ended Sept. 30, would be reauthorized as part of that legislation.

But Wednesday, Sens. Lamar Alexander, R-Tenn., chairman of the Senate health committee, and Sen. Susan Collins, R-Maine, a key player in this drama, said in a joint statement, "It has become clear that Congress will only be able to pass another short-term extension to prevent a government shutdown and to continue a few essential programs.”

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They said their health care proposal, which includes several initiatives including the CHIP funding, would be offered early next year.

The funding uncertainty is causing states to limit or freeze their CHIP enrollment and notify parents what to do if they lose coverage.

Twenty of the 25 states cited by Georgetown, including California, Florida, Pennsylvania and Washington, have already received nearly $1.2 billion in emergency funding to keep their programs running.

The CHIP program, which covers nearly 9 million U.S. youngsters and provides prenatal care for roughly 370,000 expectant mothers, has been in political limbo.

A short term funding “patch” passed by Congress was supposed to provide CHIP funding to states with program shortfalls.

But because the emergency money comes from other states’ unused CHIP funds, the patch has caused nine additional states to now run low of funds. Five additional states — Georgia, Kansas, Kentucky, Rhode Island and Virginia — are now projected to exhaust their funding at the end of January, the report found.

“Another short-term patch this week would leave states in the dark as to how much funding they actually have,” said Joan Alker, Executive Director of Georgetown’s Center for Children and Families.

Eight childrens’ health and advocacy groups, including the American Academy of Pediatrics and the Children’s Defense Fund, oppose another round of short-term funding for CHIP.

“At some point states will reach a point of no return…..and we are reaching that critical point if Congress goes home without taking care of CHIP,” said Tricia Brooks, a senior fellow at the center.

The Georgetown analysis highlights the tension states are facing as Democrats and Republicans can’t agree on the source of the new funding.

A policy success story, most lawmakers assumed CHIP would be easily reauthorized. But the issue languished as congressional Republicans this year focused their attention on repealing the Affordable Care Act and passing a tax cut that was sent to President Donald Trump Wednesday.

In early November, the House passed a bill reauthorizing CHIP for five years and funding community health centers for two years. Democrats objected to the funding formula. To pay for CHIP, Republicans proposed shuttering an Obamacare disease prevention fund that provides $1 billion a year to the Centers for Disease Control and Prevention — roughly 12 percent of the CDC's annual budget.

House Democrats continue to call this plan a non-starter. In the Senate, Minority Leader Chuck Schumer of New York has said the House measure is “dead on arrival.” Unlike Democrats in the House, Schumer has some leverage, because 60 votes are needed for Senate passage and Republicans control 52 seats.

So while Republicans had originally planned to include the House GOP’s five-year extension in a short-term government spending bill to be considered by the week’s end, Democrats in both chambers have made it clear that’s one more “poison pill” that would prevent them from being able to vote to avert a shutdown.

By Wednesday morning, Republicans did not seem closer to an agreement on how to proceed.

House Republican Chief Deputy Whip Patrick McHenry of North Carolina said Wednesday that CHIP would be dealt with "somewhere" but gave no indication as to which way leaders were leaning — or when there could be a resolution.

House Majority Leader Kevin McCarthy, R-Calif., told reporters that Democrats were to blame for the standoff on reauthorizing CHIP.

"The Democrats have voted against CHIP twice. We have passed CHIP," McCarthy said. "So I guess the agreement would have to be the Senate would have to bring it up or Schumer would have to let it go through. We've already legislated on CHIP."

When asked specifically whether CHIP would be included in the year-end spending bill or advanced as separate legislation in the three days Congress is likely to meet before leaving for the year, McCarthy demurred.

"I didn't say we're putting it in the (spending bill), I'm saying we've already legislated twice. Democrats have voted against it. I think that's devastating," he said, citing CHIP legislation the House passed earlier this year.

On the Senate side of the Capitol, Senate Majority Whip John Cornyn, R-Texas, called addressing CHIP by the end of a year “a priority for me.

“We need some certainty,” he said. But he declined to provide details about how the issue could be resolved this year.

Democrat Doug Jones won election for the U.S. Senate from Alabama, defeating Republican Roy Moore on Tuesday. Jones is an attorney and former prosecutor.

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