The GOP Has Officially Engineered a Children’s Health-Care Crisis
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To keep the program going, states with unspent federal CHIP money have seen their excess sent to a handful of states running low on funds. But that is a bureaucratic band-aid; some large states are warning families they may not be able to rely on CHIP for much longer.
All told, CMS has given out $1.2 billion in redistribution dollars since October. To keep the program going would cost the federal government $8.5 billion over five years, the Congressional Budget Office estimates.
Saturday marks the 25th anniversary of Pennsylvania approving the original CHIP program, which served as a model for the national law, established in 1997. Since then, CHIP has been left in the fiscal lurch only once before. In 2007, CHIP went several weeks without funding authorization from Congress.
Here’s a quick look at what the shortfall may mean to daily life.
1. Are any kids hurting because Congress has failed to fund CHIP?
No. But states such as California will run out of money within weeks. That state alone accounts for nearly 15 percent of all children benefiting from CHIP. Without federal money, state programs could freeze enrollment or suspend operation.
2. What are states doing since Congress missed the deadline?
Most states are doing little except looking for other unspent federal funds or asking the federal government to send some unspent funds from other states. But some, such as Colorado, are sending warning letters to beneficiaries to tell them that the program could soon end and to look for alternatives. This could mean exploring the ACA marketplace for coverage or researching if a child qualifies for Medicaid.
Colorado said it has only enough CHIP funding to last through January and then the program, without federal dollars, will end.
Arizona officials announced Thursday that it will use Medicaid funding to fill in the shortage of CHIP dollars to extend the life of its CHIP program.
Virginia officials plan to send out a similar notice to parents of CHIP members by early this month.
Minnesota is keeping CHIP alive by paying the federal share with state funds.
In Oregon, Democratic Gov. Kate Brown recently said that she is ready to spend $35 million in state funds to keep CHIP running through December.
Nevada this week announced it had been approved for extra funding from the Centers for Medicare & Medicaid Services — nearly $5.7 million — which could keep CHIP alive through December and possibly January.
California, which leads the nation in CHIP enrollment, has received the lion’s share of CMS redistribution funds since October: nearly $692 million.
“Approximately 98 percent of the 1.3 million population now covered using CHIP funding would continue to receive coverage under the Medicaid program because of a legal obligation to cover them through September 2019,” said California Medicaid/CHIP spokesman Tony Cava. “If CHIP is not reauthorized, the governor and Legislature would need to deliberate on how best to address the population no longer eligible for federal CHIP funding.”
4. If CHIP is so popular among Republicans and Democrats, what’s the problem?
There is little debate about its worth and value, but the momentum on CHIP was lost amid disagreements over the Affordable Care Act. The House did extend authorization with a vote —mostly along party lines — on Nov. 3. The Senate itself has yet to vote. The Senate Finance Committee on Oct. 3 approved a bipartisan bill to extend the program for five years.
The sticking point is not whether to keep CHIP running but how to raise the cash needed.The House agreed to charge higher premiums to wealthier Medicare beneficiaries, cut money from the ACA’s preventive health fund and shorten the grace period for ACA enrollees who fail to make monthly premium payments.
Like the House bill, the Senate committee bill eliminated an ACA provision to increase CHIP matching funds — to states — by 23 percent. The increased funding would continue through fiscal year 2019 and fall to 11.5 percent in fiscal year 2020. It would be cut entirely in the following fiscal year.
5. How does CHIP differ based on where you live?
CHIP income eligibility levels vary by state. About 90 percent of children who qualify are from families earning 200 percent of poverty or less ($40,840 for a family of three). CHIP covers children up to age 19. But states have the option to cover pregnant women, and 18 states plus the District of Columbia do so.
And some states call CHIP by different names. For example, it is known as Hoosier Healthwise in Indiana, PeachCare for Kids in Georgia and KidsCare in Arizona.
With CHIP In Limbo, Here Are 5 Takeaways On The Congressional Impasse
Excuse the next series of posts, but I need you to see how dire the situation has been and the progression of ain't shytness with some of these republican proposals.
I'll try to put the dates of these developments so that you're not confused past this point.
Edit: Also, the articles give great insight into some positive aspects of the ACA/Obama legacy that are unknown to most people
I'll try to put the dates of these developments so that you're not confused past this point.
Edit: Also, the articles give great insight into some positive aspects of the ACA/Obama legacy that are unknown to most people
Last edited:
From September:
Ninety thousand Missouri children and 80,000 in Kansas are at risk of losing their health insurance if Congress does not act before the end of September to fund the Children’s Health Insurance Program, or CHIP.
Kids win when Congress funds Children’s Health Insurance Program
States won’t exhaust their CHIP funding immediately. Three states and Washington, D.C. are expected to run out of money by December, and the majority of states will deplete their federal dollars by March, according to a July report from the Medicaid and CHIP Payment and Access Commission.
A more recent study from the Kaiser Family Foundation found that 10 states would run out of money by the end of year (of the 41 states and Washington, D.C., that responded to the survey).
“It impacts state budgets because the vast majority of states have assumed in their budgets — and of course, most of them are already done with their budgets — that Congress would still fund CHIP at the full level that it’s authorized for,” said Joan Alker, executive director of Georgetown’s Center for Children and Families.
The panel had been examining coupling CHIP funding with money for community health centers and other extenders. There’s also another bipartisan bill in the House that would extend funding for these health centers for five years with moderate increases.
ObamaCare created a special trust fund for community health centers — and that was extended again in 2015 to the tune of $7.2 billion for two years. This pool of money accounts for more than 70 percent of the federal grant funds for community health centers.
In early September, more than 70 national groups sent a letter to congressional leaders where they pointed to the stakes:
“According to [the Department of Health and Human Services'] own estimates, a failure to renew these funds would lead to loss of 51,000 jobs, closure of 2,800 [community health center] delivery sites, and a loss of access to care for more than nine million patients,” the groups wrote.
Congress on track to miss two big health deadlines
Ninety thousand Missouri children and 80,000 in Kansas are at risk of losing their health insurance if Congress does not act before the end of September to fund the Children’s Health Insurance Program, or CHIP.
Kids win when Congress funds Children’s Health Insurance Program
States won’t exhaust their CHIP funding immediately. Three states and Washington, D.C. are expected to run out of money by December, and the majority of states will deplete their federal dollars by March, according to a July report from the Medicaid and CHIP Payment and Access Commission.
A more recent study from the Kaiser Family Foundation found that 10 states would run out of money by the end of year (of the 41 states and Washington, D.C., that responded to the survey).
“It impacts state budgets because the vast majority of states have assumed in their budgets — and of course, most of them are already done with their budgets — that Congress would still fund CHIP at the full level that it’s authorized for,” said Joan Alker, executive director of Georgetown’s Center for Children and Families.
The panel had been examining coupling CHIP funding with money for community health centers and other extenders. There’s also another bipartisan bill in the House that would extend funding for these health centers for five years with moderate increases.
ObamaCare created a special trust fund for community health centers — and that was extended again in 2015 to the tune of $7.2 billion for two years. This pool of money accounts for more than 70 percent of the federal grant funds for community health centers.
In early September, more than 70 national groups sent a letter to congressional leaders where they pointed to the stakes:
“According to [the Department of Health and Human Services'] own estimates, a failure to renew these funds would lead to loss of 51,000 jobs, closure of 2,800 [community health center] delivery sites, and a loss of access to care for more than nine million patients,” the groups wrote.
Congress on track to miss two big health deadlines
From October:
9 million kids get health insurance under CHIP. Congress just let it expire.
The program, created under a 1997 law passed with bipartisan support during the administration of President Bill Clinton, provided coverage for children in families with low and moderate incomes as well as to pregnant women. It was instrumental in lowering the percentage of children who were uninsured from nearly 14 percent when it started to 4.5 percent in 2015. It was last reauthorized in 2015 and was due to be renewed by Sept. 30, 2017.
Amid unsuccessful efforts to repeal and replace the Affordable Care Act, the Republican-led Congress allowed the CHIP deadline to pass without action.
The program cost the federal government about $13.6 billion in 2016. The program provided services that included, according to the government’s website:
Routine “well child” doctor and dental visits are free under CHIP. But there may be co-payments for other services. Some states charge a monthly premium for CHIP coverage. The costs are different in each state, but you won’t have to pay more than 5% of your family’s income for the year.
That could soon change.
Dorothy R. Novick, a pediatrician at Children’s Hospital of Philadelphia, recently penned a plea to Congress to save CHIP, writing in The Washington Post:
Every day I see patients in my practice who stand to lose their health care if Congress does not act to extend CHIP funding. Consider my patient who grew up in foster care, put herself through college and now earns a living as a freelance clothing designer. She is now a mother herself, and I treat her children. Her 1-year-old son has asthma and her 3-year-old daughter has a peanut allergy. They are able to follow up with me every three months and keep a ready supply of lifesaving medications because they qualify for CHIP.
Or consider the dad with a hearing impairment whose wife passed away two years ago. He supports his teenage daughters by working as a line cook during the day and a parking attendant at night. He sends the girls to a parochial school. He lost their Medicaid when he was given extra hours at his restaurant last year. But I still see them because they qualify for CHIP.
9 million kids get health insurance under CHIP. Congress just let it expire.
9 million kids get health insurance under CHIP. Congress just let it expire.
The program, created under a 1997 law passed with bipartisan support during the administration of President Bill Clinton, provided coverage for children in families with low and moderate incomes as well as to pregnant women. It was instrumental in lowering the percentage of children who were uninsured from nearly 14 percent when it started to 4.5 percent in 2015. It was last reauthorized in 2015 and was due to be renewed by Sept. 30, 2017.
Amid unsuccessful efforts to repeal and replace the Affordable Care Act, the Republican-led Congress allowed the CHIP deadline to pass without action.
The program cost the federal government about $13.6 billion in 2016. The program provided services that included, according to the government’s website:
- Routine checkups
- Immunizations
- Doctor visits
- Prescriptions
- Dental and vision care
- Inpatient and outpatient hospital care
- Laboratory and X-ray services
- Emergency services
Routine “well child” doctor and dental visits are free under CHIP. But there may be co-payments for other services. Some states charge a monthly premium for CHIP coverage. The costs are different in each state, but you won’t have to pay more than 5% of your family’s income for the year.
That could soon change.
Dorothy R. Novick, a pediatrician at Children’s Hospital of Philadelphia, recently penned a plea to Congress to save CHIP, writing in The Washington Post:
Every day I see patients in my practice who stand to lose their health care if Congress does not act to extend CHIP funding. Consider my patient who grew up in foster care, put herself through college and now earns a living as a freelance clothing designer. She is now a mother herself, and I treat her children. Her 1-year-old son has asthma and her 3-year-old daughter has a peanut allergy. They are able to follow up with me every three months and keep a ready supply of lifesaving medications because they qualify for CHIP.
Or consider the dad with a hearing impairment whose wife passed away two years ago. He supports his teenage daughters by working as a line cook during the day and a parking attendant at night. He sends the girls to a parochial school. He lost their Medicaid when he was given extra hours at his restaurant last year. But I still see them because they qualify for CHIP.
9 million kids get health insurance under CHIP. Congress just let it expire.
From October:
House Republicans propose Puerto Rico funding as part of CHIP bill
Republicans on a leading House health-care committee are proposing to send $1 billion in extra Medicaid funding to Puerto Rico as it deals with severe hurricane damage, as part of a five-year plan to fund the federal health insurance program for children.
The proposal from the House Energy and Commerce Committee, provided Monday night to The Washington Post, would be paid for with a bucket of items, including raising Medicare rates for wealthier seniors, redirecting dollars from the Affordable Care Act’s prevention fund and shortening a grace period for enrollees who don’t pay their premiums.
The Energy and Commerce bill proposes the following funding mechanisms:
— Charging higher Medicare premiums to seniors earning more than $500,000: $6 billion.
— Allow states to dis-enroll lottery winners from Medicaid: $400 million.
— Shorten the grace period for ACA enrollees who don’t pay their marketplace premiums from 90 days to 30 days: $5 billion.
— Redirect money from the ACA’s prevention and public health fund to community health centers: $5.5 billion.
— Strengthen Medicaid’s third-party liability policy by making it easier for state programs to avoid some medical costs if they’re already covered by private plans or other government programs: nearly $4 billion.
House Republicans propose Puerto Rico funding as part of CHIP bill
House Republicans propose Puerto Rico funding as part of CHIP bill
Republicans on a leading House health-care committee are proposing to send $1 billion in extra Medicaid funding to Puerto Rico as it deals with severe hurricane damage, as part of a five-year plan to fund the federal health insurance program for children.
The proposal from the House Energy and Commerce Committee, provided Monday night to The Washington Post, would be paid for with a bucket of items, including raising Medicare rates for wealthier seniors, redirecting dollars from the Affordable Care Act’s prevention fund and shortening a grace period for enrollees who don’t pay their premiums.
The Energy and Commerce bill proposes the following funding mechanisms:
— Charging higher Medicare premiums to seniors earning more than $500,000: $6 billion.
— Allow states to dis-enroll lottery winners from Medicaid: $400 million.
— Shorten the grace period for ACA enrollees who don’t pay their marketplace premiums from 90 days to 30 days: $5 billion.
— Redirect money from the ACA’s prevention and public health fund to community health centers: $5.5 billion.
— Strengthen Medicaid’s third-party liability policy by making it easier for state programs to avoid some medical costs if they’re already covered by private plans or other government programs: nearly $4 billion.
House Republicans propose Puerto Rico funding as part of CHIP bill
From October:
States rush to preserve children's health coverage
Without getting new funding from Congress soon, Minnesota is considering tapping into its unspent federal allotment for 2017, which would fund the program for about nine months. Doing so, however, would come with a federal penalty of $10 million to the state.
"It would carry us forward, but it would be a financial strain to the state's budget," Piper said.
CHIP, now in its 20th year, is jointly funded by the federal government and the states. Historically, the federal government has provided an average of 71 percent of the funding, but a provision in the Affordable Care Act boosted federal funding to the states by 23 percentage points over the past two years.
Like Minnesota, Utah is considering moving eligible children to Medicaid if the money runs out, said Utah Medicaid Director Nate Checketts. The state is also considering moving some kids to the Obamacare insurance marketplaces, where they can get subsidized coverage. However, officials are still working through the logistics.
Colorado is also looking at Obamacare's marketplaces as a fallback option. The state's CHIP program, which is expected to run out of money by the end of January without action from Congress, plans to notify families in mid-December that coverage may be terminated, triggering a qualifying event that allows them to purchase Obamacare coverage through the state's exchange. More than 75,000 children and nearly 800 pregnant women are currently enrolled in Colorado's program.
California's Department of Health Care Services said it's still business as usual for the state's CHIP program, which receives more than $2 billion a year and covers about 1.3 million children and pregnant women. The program is expected to run out of funding in December.
“Right now, it is a tough balance between the reality of a true urgency facing state CHIP programs and not wanting to create panic for families whose children depend on CHIP coverage,” said Kristen Golden Testa, director of the California health program at The Children’s Partnership.
In Texas, funding is expecting to dry up in January or February for a program covering nearly 400,000 children and 36,000 pregnant women in the state. Texas budget writers estimated Texas would receive $3.2 billion in federal funding for CHIP over 2018 and 2019.
States rush to preserve children's health coverage
States rush to preserve children's health coverage
Without getting new funding from Congress soon, Minnesota is considering tapping into its unspent federal allotment for 2017, which would fund the program for about nine months. Doing so, however, would come with a federal penalty of $10 million to the state.
"It would carry us forward, but it would be a financial strain to the state's budget," Piper said.
CHIP, now in its 20th year, is jointly funded by the federal government and the states. Historically, the federal government has provided an average of 71 percent of the funding, but a provision in the Affordable Care Act boosted federal funding to the states by 23 percentage points over the past two years.
Like Minnesota, Utah is considering moving eligible children to Medicaid if the money runs out, said Utah Medicaid Director Nate Checketts. The state is also considering moving some kids to the Obamacare insurance marketplaces, where they can get subsidized coverage. However, officials are still working through the logistics.
Colorado is also looking at Obamacare's marketplaces as a fallback option. The state's CHIP program, which is expected to run out of money by the end of January without action from Congress, plans to notify families in mid-December that coverage may be terminated, triggering a qualifying event that allows them to purchase Obamacare coverage through the state's exchange. More than 75,000 children and nearly 800 pregnant women are currently enrolled in Colorado's program.
California's Department of Health Care Services said it's still business as usual for the state's CHIP program, which receives more than $2 billion a year and covers about 1.3 million children and pregnant women. The program is expected to run out of funding in December.
“Right now, it is a tough balance between the reality of a true urgency facing state CHIP programs and not wanting to create panic for families whose children depend on CHIP coverage,” said Kristen Golden Testa, director of the California health program at The Children’s Partnership.
In Texas, funding is expecting to dry up in January or February for a program covering nearly 400,000 children and 36,000 pregnant women in the state. Texas budget writers estimated Texas would receive $3.2 billion in federal funding for CHIP over 2018 and 2019.
States rush to preserve children's health coverage