CHIP Turns 20: Happy Birthday?

August 4, 2017



This Saturday marks the twentieth anniversary of the Children’s Health Insurance Program (CHIP), which was signed into law on August 5th, 1997 by President Bill Clinton as part of the Balanced Budget Act. CHIP and its companion Medicaid, have done an amazing job of reducing the number of uninsured children in Ohio and across the country to historic lows in 2015. While the vast majority of these children are covered in Medicaid, CHIP stimulated an enormous, national, bipartisan effort to prioritize covering children — through outreach efforts, eligibility simplifications for both programs, and of course new coverage opportunities for children whose families were earning a bit too much for Medicaid but not enough to afford private insurance.At last check, more than 95% of Ohio children had coverage.


Assessing where CHIP stands on the eve of its 20th birthday is a little worrisome, though. Funding for CHIP expires on September 30th, 2017. In a hopeful sign, Senator Orrin Hatch, Chairman of the Senate Finance Committee, announced a bipartisan hearing on CHIP in September. The House Energy and Commerce Committee held a hearing on CHIP earlier this year but so far Congress has taken no action at all to extend CHIP funding. Only 56 days remain before CHIP runs out of money and Congress is not in session for the vast majority of those days. Ohio families, meanwhile, have no assurances about what is going to happen.


We all know why Congress has been distracted. And the good news for CHIP is that Medicaid and its financing structure has emerged unscathed for now. CHIP wouldn’t be able to operate as successfully as it does without standing on the shoulders of Medicaid. Voices and our fellow advocates have been urging Congress since February to act quickly on CHIP, noting that it could be a relatively quick and easy bipartisan health care win as compared to other pending health policy issues! But, no action was taken and now the CHIP program faces its birthday with a huge amount of uncertainty for those who rely on the program for their children’s coverage as well as the state administrators and legislators who run and budget for the program. Will the match rate change? How long will the program be extended for? What will happen to the maintenance of effort requirement that ensures that states like Ohio must keep their coverage stable for children in this time of turmoil? How can Ohio even run a responsible program with contracting obligations etc in this situation?


Advocates are calling for a five-year extension of CHIP with the MOE and the match intact until FY 2022, which would be the responsible choice to make as it is extremely important to protect children from losing health coverage during these tumultuous times. This is even more important now as it seems clear that the marketplace is fated with uncertainty at best in the near future and active sabotage at worst. And of course the biggest question is will the program be extended at all? While we doubt that Congress will let this funding expire, we do have growing concerns given the disarray and the huge agenda Congress faces in September – which includes funding not just CHIP but all aspects of government – and raising the debt ceiling.


For the nearly 9 million children whose coverage is financed and/or provided through CHIP, this is a very serious matter with real consequences. By acting quickly and responsibly as soon as it returns, Congress could provide parents with peace-of-mind on the concern that is on the top of their minds – their child’s health.

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