Where Does CHIP Stand Now?Health
For families, providers, advocates, state officials, governors, and members of Congress, September 30th was a significant day in the world of CHIP, the Children’s Health Insurance Program. That’s the day that the funding for CHIP expired. Over the last twenty years, along with Medicaid, CHIP coverage has brought the children’s uninsured rate to a record low of 5%. Across the country, CHIP covers almost 9 million kids. Though advocates and state officials have been pushing for CHIP’s funding renewal since January, the repeal and replace ACA bills took up all the health policy space in Congress over the last six months.
Failing to pass a funding renewal for CHIP by the end of September seems to have prompted the two mark-up hearings we saw last week, one in the Senate Finance Committee and the other in the House Energy and Commerce Committee. Each committee marked up a different bill, but the policies included are closely aligned. The House bill was part of a package of bills that were marked up and all included some type of pay-fors. The Senate bill did not contain a pay-for for CHIP.
Generally, advocates are pleased with the policies in each bill. They include:
- Renewing CHIP for five years, through FY2022;
- Maintaining current law in terms of the 23% FMAP “bump” from the ACA (FY2018-2019) with a decrease to 11% in FY2020 for one year;
- Maintaining the MOE, Maintenance of Effort at 300% FPL until FY 2022
- Extending Express Lane Eligibility for five years;
- Extends Outreach and Enrollment grants (The House added an amendment to include Parent Mentors as an outreach option). SEE ALSO: Glenn Fores, MD, FAAP on “Mothers Mentoring Mothers”
Both bills passed out of their respective committees. The Senate bill passed on a voice vote and the House bill passed on a bipartisan vote with Democratic members voting against the bill due to the pay-fors. The agreement on the big policy questions is a win for kids and states. A five-year extension of CHIP means states make improvements in their program design as well as negotiate strong contracts with providers and vendors. Keeping Express Lane for five years supports the states that use it and may bring others on board. The FMAP bump is critical for the next couple years for state budgets cycles, and the MOE will help ensure that kids stay on coverage.
Without pay-fors in the Senate and with partisan support for the pay-fors coming from the House, the next step for CHIP is unclear. If the House and Senate leadership agree on pay-fors and a vehicle, CHIP could move though. Without those agreements, we are unsure as to when it could go forward through Congress.
What can you do to help get CHIP over the finish line? Reach out to your governors and state legislators and ask them to contact your congressional delegation about CHIP. Call your member offices today and ask them about CHIP. Tell them you want to see a bipartisan agreement and you want it passed soon. Motivate members who aren’t on the committees of jurisdiction to stand up for CHIP and kids. Now is the time for public pressure to build in member’s home states. They will be home in their districts during the next two weeks, and the more local questions they get and press they see about CHIP, the better.
Remember, CHIP is a very popular, bipartisan, long-standing program that has done the work it needed to do for over 20 years. Kids are covered now at a higher rate than ever before. We can’t go back.
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