Congress is exploiting its own neglect to bargain over CHIP’s renewal

Last weekend, nine million children lost federal funding for health care in America

Intense debate over the failed Graham-Cassidy bill to overturn ObamaCare distracted Congress from renewing the Children’s Health Insurance Program (CHIP). Lawmakers were literally too busy trying to strip health care from 32 million. Americans and patients with pre-existing conditions to renew coverage for vulnerable children in working class families.

CHIP was signed into law in 1997 with strong bipartisan support. It covers uninsured children whose modest family incomes are too high to qualify for Medicaid yet too low to pay for private health insurance. A family of four, for example, making more than $33,000, but less than $50,000, could still obtain coverage through CHIP. Closing this gap in coverage for working class families has been instrumental in dramatically reducing the number of uninsured children in America. According to the U.S. Census Bureau, the percentage of children who were uninsured when CHIP first started was 15.0 percent compared to just 5.4 percent last year.

At an annual cost of roughly $13.6 billion, CHIP covers everything from routine clinic visits to inpatient hospital stays and emergency services. CHIP also pays for preventative care that benefits all children, even those outside the program. For example, by covering routine vaccinations for measles, mumps, rubella, chicken pox, and other communicable diseases, CHIP helps prevent outbreaks of diseases throughout the entire pediatric population.

After allowing CHIP to expire, House Republicans are proposing a new bill to fund the program. At first glance it looks appealing. By taking Medicaid away from lottery winners who don’t need it and charging higher Medicare premiums to wealthy seniors who can afford it, the bill funds CHIP for 5 years. It even promises an extra $1 billion in Medicaid funding to storm-ravaged Puerto Rico.

But Andy Slavitt, former acting administrator of the Centers for Medicare and Medicaid Services told me that while “kids and Puerto Rico are two significant priorities,” he is “concerned about having Medicare patients and low-income people pay for this [bill].”

Slavitt has a point. There are deeply disturbing details within the bill. The lottery winner clause, for example, appears to be a gimmick. It only accounts for $400 million in expected savings while the bill earns $5 billion by shortening the payment grace period for ACA marketplace premiums from 90 to 30 days.

This disproportionately hurts low income Americans who live paycheck to paycheck. In fact, with anticipated penalties and interest charges for late payments, the bill stealthily charges a tax on those who can least afford it.

Moreover, the bill saves $5.5 billion by making cuts to the ACA’s prevention and public health fund and another $4 billion by adjusting Medicaid’s third party liability policy. These further cuts serve to undermine both the ACA and Medicaid. 

Through their callous oversight, Congressional Republicans already allowed CHIP to expire. Now Congress is exploiting its own neglect to bargain over CHIP’s renewal. In fact, if funding is not soon restored, states will quickly drain what little money they have left for CHIP. Some may even run out of funds as early as next month.  

It is unconscionable for Republicans to use this sense of urgency that they themselves created to make cuts to both the ACA and Medicare. It is almost shocking that they seek to be rewarded for their own mistake at the expense of American children and low income households. The most logical, fair, and straightforward solution is for Congress to pass a no-nonsense renewal of CHIP. They have always done so in the past and the only difference this time is that Congress has an even more compelling reason to quickly rectify their misdeeds. 

Dr. Eugene Gu is a resident physician at the Vanderbilt University Medical Center and president of the Ganogen Research Institute. He graduated from Stanford University with honors and holds an M.D. from the Duke University School of Medicine.