The GOP Has Officially Engineered a Children’s Health-Care Crisis

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From December:
Ducey was quiet on funding request for kids health care, until he heard from the media
It took media inquiries in late October to figure out Gov. Doug Ducey's position on whether Congress should renew funding for a children's health-insurance program. The short answer: He supports kids.

But a records request by The Arizona Republic filed before talking to the governor found Ducey wasn't doing much outreach to the folks who could make a difference — at least not until reporters started asking about it.

Records show the offices of Republican U.S. Reps. Martha McSally and David Schweikert contacted Ducey's staff on Sept. 12 and Oct. 2, respectively, to find out what the funding lapse would mean. They got prompt responses from Christina Corieri, a senior policy adviser, on how many kids would be affected.

But there was no communication from Ducey to the congressional delegation on the program's future until Nov. 1, when he wrote a letter urging continuation of the Children's Health Insurance Program. It's known as KidsCare in Arizona.
https://www.azcentral.com/story/new...uest-kidscare-until-he-heard-media/933267001/



U. of C. medical students rally for Congress to renew children's health insurance program
More than 50 medical students and others gathered at Federal Plaza on Thursday to decry Congress’ failure to reauthorize funding for the Children’s Health Insurance Program before it expired in late September. About 255,000 children in Illinois receive coverage through the program, which is meant to help kids whose families make too much to qualify for Medicaid but still can't afford private insurance.

Illinois has enough funding left to continue the program through September 2018, according to the Illinois Department of Healthcare and Family Services. Other states expect to run out of funds much sooner. About half of the children in Illinois who now benefit from the program would still likely be covered by Medicaid even if the state ran out of funding, according to the state. The other half could lose coverage in late 2018 if Congress hasn't reauthorized the program by then.
U. of C. medical students rally for Congress to renew children's health insurance program

State pledges to sustain child health program, even if Congress fails to provide funding
“We technically would run out of money in mid-January, but through administrative actions we could take, we would be able to maintain the CHIP program for the rest of this fiscal year,” which ends on June 30, she said.

Without continued federal funding, Massachusetts is at risk of losing about $148 million in the current fiscal year and $295 million annually after that, state officials said — a significant hit to an already stretched state health care budget.
State pledges to sustain child health program, even if Congress fails to provide funding - The Boston Globe

 

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From December:
No bah humbug? Texas won't mail notices canceling poor kids' health coverage before Christmas
Federal officials have given a health insurance program for low-income Texas children a short-term funding boost to extend the kids’ coverage through February, the Texas Health and Human Services commission said Friday.

The Children’s Health Insurance Program will receive nearly $136 million from the federal Centers of Medicare and Medicaid Services, executive commissioner Charles Smith said in a letter to Gov. Greg Abbott.

The infusion of federal money would allow the state commission, which runs CHIP, to delay sending cancellation letters to parents and guardians of about 400,000 children until after Christmas, commission spokeswoman Carrie Williams said.

“The projected amount would be more than sufficient for us to cover CHIP clients through the month of February (we need $90M to carry us through February),” Williams said in an email. “Given this assurance, we don’t expect to have to send client letters this month about any changes in their coverage. And, we’re confident that Texas will receive enough federal funding to continue the program through February 2018.”
No bah humbug? Texas won't mail notices canceling poor kids' health coverage before Christmas | Politics | Dallas News

Wolf signs state CHIP bill, but still no federal action
Gov. Wolf signed a bill Friday reauthorizing Pennsylvania’s participation in the Children’s Health Insurance Program (CHIP). The bigger worry, however, remains with Congress, which has yet to renew this largely federally funded program that provides health care for nearly 9 million low-income and special-needs children, as well as more than 370,000 pregnant women nationwide. Pennsylvania’s CHIP program is projected to run out of money by the end of January if federal lawmakers fail to act soon.

In Pennsylvania, state Senate Republicans sought to bar CHIP funding for gender affirmation surgery for transgender youth, though this procedure is rarely sought by people in the program. The Senate approved a version of the bill without that prohibition on Monday, clearing the way for Wolf’s signature.

A bill has been introduced in the state House of Representatives by Rep. Jesse Topper (R., Bedford) that would bar public funding such as CHIP and Medicaid for transgender surgeries for all ages. No action has been taken on the bill, which Topper said may still be revised.
Wolf signs state CHIP bill, but still no federal action

Virginia letters meant to warn, not scare or confuse, CHIP families
With the holiday season in full swing and a million other things likely on their minds, 68,000 Virginia families will receive, or have already received, a letter warning them that by the end of January, their children might not have health insurance.

That is because, for nearly three months, an effort to reauthorize a 20-year-old bill that has always been supported by both sides of the aisle has been neglected.

Nine million children nationwide depend on CHIP, or the Children’s Health Insurance Program. When sending out its letters to families last week, Virginia was intent on warning them, but not scaring them into a panic, and spent a great deal of time figuring out how to do that. There is still hope that Congress will reauthorize the program in time.

The first letter that the Department of Medical Assistance Services, or DMAS, which runs Medicaid in Virginia, sent to parents last week was a warning. It was meant to notify them that, though nothing is certain yet and though hope still swirls around Congress that it will reauthorize CHIP, their children might be uninsured come Jan. 31.
Virginia letters meant to warn, not scare or confuse, CHIP families

Families of 17,000 CT children being told health coverage may end
Letters are going out this weekend telling families that 17,000 children and teenagers across the state will lose their health coverage on Jan. 31 unless Congress acts.

Connecticut expects to run out of money on Jan. 31 unless Congress votes to keep funding the program, and right now lawmakers are mired in a partisan fight that has escalated with the GOP’s approval of a new tax bill and differences over the federal budget.

Connecticut also will stop accepting new applications for the program on Dec. 23 unless Congress acts, according to the state Department of Social Services.

The HUSKY B program covers children whose families earn too much money to qualify for Medicaid, providing health care for children for families of four earning up to $79,458 a year. It is funded largely through federal dollars, with a smaller contribution – 12 percent — from the state.
Families of 17,000 CT children being told health coverage may end

 

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From December:

Not-So-Happy New Year: Alabama Set To Toss Kids Off Insurance Plan Starting Jan. 1
Citing Congress’ failure to restore federal funding of the Children’s Health Insurance Program, Alabama plans to drop 7,000 kids from coverage on New Year’s Day, the first step to shutting down coverage for everyone, state officials said Monday.

Those children, who are up for their yearly renewal in January, will not be allowed to continue in the program, and the state also plans to freeze enrollment at the same time. Then, unless Congress acts, Alabama would close CHIP for all 84,000 children on Feb. 1.

Alabama would become the first state to cut off children’s coverage since Congress failed to renew federal CHIP funding, which expired Oct. 1.

Caldwell said Alabama estimated it would have enough money to cover claims made only through February. She said it made no sense to continue renewing coverage and adding new enrollees in January if CHIP would be ending a month later. About 7,000 children have their coverage renewed each month, she said.

Caldwell said she estimates most CHIP enrollees won’t find affordable coverage without the program. Fewer than 10 percent would qualify for Medicaid, she said, and many families would find subsidized coverage for children in the Affordable Care Act’s online marketplaces too costly because it often comes with higher premiums, copayments and deductibles.

Alabama has one of the broadest eligibility levels — 317 percent of the poverty level, or $78,000 for a family of four.

Unlike Medicaid, CHIP is usually not free. Enrolled families pay an average premium of about $127 a year.

Since CHIP’s enactment, the share of uninsured children fell from 13.9 percent in 1997 to 4.5 percent in 2015, according to the Medicaid and CHIP Payment and Access Commission.

Alabama’s rate fell from 20 percent to 2.5 percent, Caldwell said.

Caldwell said the last time Alabama froze enrollment in CHIP for several months, in 2004, it took several years to convince parents that the program had reopened.

“Once we deny kids and disenroll kids, we know so many of them won’t be able to get back on,” she said.
Not-So-Happy New Year: Alabama Set To Toss Kids Off Insurance Plan Starting Jan. 1

 

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From December:
Insurance For 3,000 Kids In Wyoming In Congress's Hands
Nearly 3,000 kids in Wyoming have access to a highly subsidized health insurance through a program called Kid Care CHIP operated by the Wyoming Department of Health. Those kids could lose that coverage as soon as April, if Congress does not re-authorize funding for the Children’s Health Insurance Plan.

Kim Deti, public information officer for the Wyoming Department of Health, said close to 90 percent of the funding for Kid Care CHIP comes from the federal government, and without that funding it’s not likely the program will continue.
http://wyomingpublicmedia.org/post/...0JgDwF534SoGUsZaDAzmFcvbkAmPJA&_hsmi=59533809


Kids’ health insurance hangs in balance, and parents wonder what’s wrong with Congress
WEST JORDAN, Utah — The lingering uncertainty in Congress over the fate of the Children’s Health Insurance Program has left Ashlee and Levi Smith torn between optimism and anxiety.

As the parents of two young children who have relied on the government-backed health-care plan, the Smiths are unsure whether they should stretch their finances to put their boys, 3 and 3 months, on a private plan — or have faith that a polarized Congress will work it out.

“$1,200 for the four of us,” Ashlee Smith, 26, said, estimating the plan’s monthly cost from their two-bedroom townhouse outside Salt Lake City, where she crafts necklaces as part of the family business. “We can’t pay that and save for a mortgage, or save anything at all.”

Congress appears unlikely this week to reauthorize the Children’s Health Insurance Program, or CHIP, which has become a crucial element in broader negotiations over how to fund the government. If no decision comes by Friday, then lawmakers are likely to take up the issue in early January — but with each delay, the pressure grows on families to find their own solutions.

For the Smiths, who are Republicans, the congressional stalemate over the $15.6 billion program is bigger than a question how to pay. It is also a question of who — or what — to believe.

Over the course of the year, their faith in the GOP-led Congress has eroded. Their general disenchantment became more pronounced when lawmakers, including even their home-state senator, Orrin G. Hatch, an architect of the CHIP program, failed to secure the funding.

The Smiths have watched their GOP representatives in Washington focus on pushing politically difficult initiatives — from seeking to rescind the Affordable Care Act to enacting a sweeping tax overhaul.

CHIP was the product of a more congenial Washington. After the failure of President Bill Clinton’s health-care overhaul effort in the early 1990s, the liberal Sen. Edward Kennedy (D-Mass.) paired with Hatch, a conservative, to do something to reduce the number of uninsured children.

The idea was to fund it through settlements and taxes from the tobacco industry. In 1997, the federal government began giving block grants to states, who in turn crafted insurance plans for working-class parents. According to a study by the Kaiser Family Foundation, the program helped reduce the rate of uninsured children from 14 percent to 7 percent.

Both liberals and conservatives got something from the plan. For Democrats, there was an opportunity to show how government can help more for people who can’t afford medical care for their children. For Republicans, they got a chance to show how innovative states could be in creating their own programs.

In Utah, the federal government disbursed more than $118 million in 2016 to offer insurance plans for the parents who made too much money to qualify for Medicaid and too little to afford insurance on the federal government exchanges — that’s about $48,000 for a family of four. More than 16,000 children in Utah currently use the program.

Monica Porras, 45, who owns a small domestic and commercial cleaning business, said she has been grateful for CHIP because it allowed her to afford treatments for her 15-year-old son Abraham, diagnosed with autism.

“If there’s no CHIP, he’ll be in regression,” she said.

“There must be a misconception of who we are, that we are not hardworking, that we are not deserving,” Porras said.

The parents are uninsured, but in January they will receive coverage through a plan on the federal government’s marketplace established by the Affordable Care Act, commonly referred to as Obamacare.

Recently, as the Smiths discussed what to do about providing for the children if they get sick, they tried to make sense of these political times.

Levi Smith said he learned to love the Affordable Care Act, President Barack Obama’s health-care law, because having low insurance costs helped him see a specialist after developing gout. He liked the idea of the Republicans’ tax cut legislation, at least if it meant that filling out tax forms would become simpler.
Kids’ health insurance hangs in balance, and parents wonder what’s wrong with Congress

 

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Now articles related to the present state of CHIP:
Congress Passes Stopgap Bill to Avoid Government Shutdown Against a Friday Deadline
WASHINGTON — Congress gave final approval on Thursday to legislation to keep the government funded into January, averting a government shutdown this weekend but kicking fights over issues like immigration, surveillance and health care into the new year.

The stopgap spending bill extends government funding until Jan. 19 while also providing a short-term funding fix for the Children’s Health Insurance Program, or CHIP, whose financing lapsed at the end of September.

The House passed the bill 231 to 188, with most Republicans voting for it and most Democrats opposing it. The Senate later gave its approval, as well, in a 66-to-32 vote.

The stopgap bill provides money for CHIP and community health centers through March. And it directs the secretary of health and human services to distribute leftover CHIP funds to states with the most urgent financial problems so they do not have to shut down the program.

But the $2.85 billion provided for CHIP is far less than the five years of funds that congressional leaders had promised, and it is unclear whether those funds will be adequate.

“I do not think this is anywhere close to enough money,” said Bruce Lesley, the president of First Focus, a child advocacy group. “For a $12 billion to $14 billion program, this provides less than $3 billion for what is effectively six months” — the first half of the 2018 fiscal year, which began in October.
Congress Passes Stopgap Bill to Avoid Government Shutdown Against a Friday Deadline

States say short-term funding not enough for children’s health
State governments are warning that the short-term funding for a critical children’s health program approved by Congress on Thursday may be too little and too late.

Warning letters in at least three states have already been sent to families saying they could lose coverage for their children come Jan. 31 without new funding from Congress. Even if the new funding keeps their programs afloat, it sends a negative message to enrollees and that could cause long-term implications, experts say.

“It shakes confidence in government in general and certainly in this program,” said Linda Nablo, chief deputy director of Virginia’s Department of Medical Assistance Services. “I think we’re going to see lower enrollment for a little while, certainly.”

The short-term bill approved by the House and Senate on Thursday provides $2.85 billion in funding for states, extending the program through March 31. But states say uncertainty will persist.

“The essence we’re hearing from the states is that this helps a few states with a short-term patch, but for others it does nothing because it’s not like they’re just going to across the board give out everyone's share of the $2.85 billion,” said Bruce Lesley, president of First Focus, a children and families health advocacy group.

“They’re going to patch a few states, so there will be a few states about to hit crisis … so as these states hit crisis they’ll give them a patch but they won’t do others.”
States say short-term funding not enough for children’s health

 

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Finally, if you didn't read anything I posted, I urge you to read this article. Michael Hiltzik is a boss with his shyt. This article is from May:

Trump and Congress are about to take an ax to children's healthcare
We’ve said it before and we’ll say it again: In the ridiculous mess that is the American healthcare system, there’s one indisputable success — children’s health coverage. Over the last two decades, the uninsured rate for children under 18 has fallen from 14% to less than 5%.

Today that achievement is under threat as never before. “We’re at real risk of moving backward,” says Joan Alker, executive director of the Center for Children and Families at Georgetown University. That’s because children’s healthcare in the U.S. is heavily dependent on three public programs, Medicaid, the Affordable Care Act, and the Children’s Health Insurance Program, or CHIP.

“All three legs of that stool,” Alker says, “are uncertain or threatened.”

Republican lawmakers seldom target children’s health programs with the fervid hostility they aim at Obamacare or Medicaid, but there are pockets of opposition. As a Georgia state legislator, Secretary of Health and Human Services Tom Price voted twice, in 2007 and 2008, against expanding CHIP in his state to cover millions more kids.

President Trump and the Republican Congress are planning to cut more than $800 billion out of Medicaid funding over 10 years while converting the program to a capped block grant to the states and eliminating the ACA’s Medicaid expansion. Those provisions are in the American Health Care Act, the House GOP’s Obamacare repeal bill.

These changes inevitably would lead to a reduction in funding; the Congressional Budget Office estimates that Medicaid spending would fall by 25% by 2026, compared with what would be available under current law. And although Senate Republicans have expressed doubts about the House bill as a whole, several have endorsed the idea of steep cuts in Medicaid.

Then there’s CHIP, which currently provides low-cost or free coverage to nearly 9 million children. CHIP was created in 1997 as a program run by individual states but subsidized by the federal government, generally at a rate of 65%. CHIP was enacted as a permanent program; its funding, however, was made subject to regular reauthorization by Congress.

That has led to periodic brinkmanship over whether Congress would act in time to avoid disruption. A few months shy of the last deadline, Sept. 30, 2015, Congress reauthorized CHIP through Sept. 30, 2017. That deadline now looms.

That’s a problem, because states need months of advance notice to keep CHIP functioning. “There’s intense concern about the deadline,” says Bruce Lesley, president of First Focus, a nonprofit advocacy group for children and families. “We’ve learned from the past that states have to plan ahead — if they’re not certain a program is going to continue they have to start thinking about winding it down.”

In some states, budgets for the coming fiscal year must be enacted as early as the end of March, in others the deadline comes between April and June. The ability of states to carry CHIP past Sept. 30 also varies — some state have enough money to cover children into fiscal 2018, but some will run out before the end of this year.

Even though CHIP is often regarded as a stand-alone program, its fate is inextricably entwined with both Medicaid and the Affordable Care Act. In many states, CHIP is integrated with Medicaid, so cuts to Medicaid will affect its funding, too. The ACA, furthermore, gave all states a bump in the federal share of CHIP funding of 23 percentage points through fiscal 2019. In 17 states including California, that brought the federal match to 88%, and in 11 states plus the District of Columbia, it rose to 100%. Although CHIP funding isn’t affected by the House Obamacare repeal bill, any wholesale repeal of the ACA would take the increase away.

CHIP is designed to fill in the coverage gap for children between Medicaid eligibility and the ACA or employer insurance. As the Center on Budget and Policy Priorities explains, prior to the ACA, state Medicaid programs had to cover children under age 6 with family incomes below 133% of the poverty line. The ACA extended coverage to all children up to age 18 in those households.

States can set their own CHIP eligibility ceilings, but most states provide coverage for children in homes with income of 200% of the federal poverty line or less. For a family of four, that cap would be income of $48,600. The average premium and cost sharing charged nationwide came to $158 per year per child in 2015. That’s well below what those families would pay for employer plans or Obamacare silver plans.

The good news is that CHIP always has received bipartisan support. Though it was enacted as a voluntary program, within three years of its passage CHIP had been accepted by every state. Just last week, the National Governors Assn. urged Congress to reauthorize CHIP to give states “certainty” about the program’s future, in a letter co-signed by its chair, Virginia’s Democratic Gov. Terry McAuliffe, and vice-chair, Massachusetts’ Republican Gov. Charlie Baker.

The bad news is that even if the program isn’t the target of the hostility that Republicans customarily aim at Medicaid, it’s threatened by congressional dysfunction in general and GOP dithering over healthcare generally. Every time the Trump White House throws Capitol Hill a curve ball — the James Comey firing merely the latest in a long sequence — doubts rise that Congress will get its act together in time to reauthorize CHIP. “We’re definitely freaking out that the base work Congress has to do is not getting done,” Lesley says.

That’s why the Medicaid and CHIP Payment and Access Commission (MACPAC), a nonpartisan congressional advisory body, recommended in January that CHIP be extended by five years to 2022. The idea was to inoculate the program, at least temporarily, from “heightened… uncertainty about the stability of the exchange market” and proposals to “change the structure and financing of the Medicaid program.”

MACPAC also recommended extending the 23-point funding bump to 2022 and eliminating a six-month waiting period imposed on children who lose employer-sponsored insurance.

Even if CHIP wins timely reauthorization, it’s the attack on Medicaid that really threatens children’s health, Alker points out. While CHIP covers nearly 9 million kids, Medicaid covers 37 million.

Republican rhetoric about Medicaid expansion covering “able-bodied” low-income adults at the expense of the children covered by traditional Medicaid is a smokescreen. “That’s pitting children against their parents,” she says. “We know that covering parents is good for children. Healthy parents are better parents. And when one person is uninsured, the whole family is exposed to financial insecurity.”

Republicans’ stated devotion to children’s welfare is aimed at distracting the public from the truth that their healthcare proposals would have a devastating effect on children. If their plans — especially their attack on Medicaid — go through, the result will be a massive public health crisis. It shouldn’t be allowed to unfold in secret.
Trump and Congress are about to take an ax to children's healthcare

 

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But Erin Miller, vice president of health initiatives with the Colorado Children's Campaign, says those reserves are almost tapped, and unless Congress restores funding, some 90,000 children and pregnant women who rely on the program annually could lose coverage.

the pro-life party y'all.