The fate of the Affordable Care Act may be deeply divisive, but there’s one aspect of the health care system that retains broad support across the political spectrum — the Children’s Health Insurance Program. Created in 1997 from the ashes of President Bill Clinton’s failed health care reform plan, it provides health insurance coverage for about 9 million children nationwide whose families make too much to qualify for traditional Medicaid but not enough to afford health insurance on their own.
Its impacts have been far reaching; a 2014 Kaiser Family Foundation report summarized the research on its effectiveness, finding “strong evidence” that the program expanded the number of children who had coverage, increased the quality of the care they received, strengthened low-income families’ finances and even bolstered student performance based on improvements to children’s health.
But Congress is so screwed up that, as of last weekend, it allowed the program to expire. A bipartisan deal was in the works in the Senate, but Republicans in both chambers got distracted by yet another attempt to repeal the Affordable Care Act, and the deadline to re-authorize funding for CHIP passed on Saturday.
That doesn’t mean all 9 million children lose health insurance right away. The program is administered by the states, and they generally have leftover funds from previous years. A few locales are expected to run out of money quickly, but most will be able to keep their programs going into the next calendar year.
Consequently, some Republicans in Congress have downplayed the urgency of the situation, saying they will be able to act before kids start getting kicked off of coverage. That may not be true in every state.
A House committee is scheduled to hold a hearing on renewing CHIP Wednesday, and advocates were cheered to learn Tuesday that the bill it will consider is in the same posture as the Senate’s in terms of the five-year reauthorization and gradual wind-down of the enhanced subsidy. But the House hasn’t figured out how to pay for it yet either, and particularly in that chamber, an agreement by the leadership has been no guarantee recently of ultimate success.
There’s not much time. In addition to Minnesota, several other states are expected to start on Nov. 1 to send families notice that the program will end. At the very least, that means anxiety and confusion for families that could entirely have been avoided if Congress had simply done its job before Oct. 1. At worst, children will start losing health insurance coverage, and states will be on the hook for hundreds of millions in extra costs. Congress needs to correct its mistake and send a CHIP reauthorization to the president immediately.