CHIP public health program needs long-term funding

Susan Kitchell was just starting her career as a school nurse when the Children's Health Insurance Program (CHIP) was signed into law in 1997. The program provides states with federal matching funds if they provide health coverage to children in families with incomes too high to qualify for Medicaid but who can't afford private coverage. The program enjoys bipartisan support and successfully serves nearly 9 million children each year. In fact, both Medicaid and CHIP provide children with better access to care, fewer unmet healthcare needs, and greater financial protection than children who were uninsured.

That's why Kitchell finds it hard to believe lawmakers have yet to act to extend funding for the program. "We're talking about providing routine care for children as well as chronic care," says Kitchell, who is a member of the United Educators of San Francisco.

CHIP expired on Sept. 30, 2017. States were able to continue to operate their programs in the short term with leftover CHIP funds from fiscal year 2017. In December, Congress approved $2.85 billion in CHIP funding as part of the Continuing Resolution that expires on Jan. 19—this Friday. The funds are supposed to help states get through March. However, a recent report by the Georgetown University Center for Children and Families suggests that an estimated 24 states (including Washington, D.C.) could face a shortfall, forcing some of them to freeze enrollment if Congress does not approve permanent funding for CHIP this month.

"Not having access to healthcare is a great divider. For this to happen to the most vulnerable is horrific. For families who make too much money for Medicaid, CHIP is their fallback," says Kitchell. "CHIP is a public health measure. It increases students' ability to attend school. That's why it's important for school nurses' voices to be heard on this issue."

There are reports that congressional leaders will push for a six-year extension of CHIP on Jan. 19, the next government funding deadline. But recent news from the Congressional Budget Office should open the door for a longer-term solution. A few months ago, the CBO estimated it would cost $8.2 billion to finance the program for five years. More recently, the CBO said extending funding for CHIP for 10 years could actually save the government money. It costs more to pay for the costs of the alternatives to providing coverage through CHIP (primarily Medicaid, subsidized coverage in the marketplaces, and employer-based insurance) than paying for the program.

That should make it easier for lawmakers to agree on a way to pay for funding and extend the program. There's still time to take action: Call your members of Congress at (202) 224-3121 and urge them to pass long-term funding for CHIP.

[Adrienne Coles]