The health of thousands of Montana children and 9 million other American kids remains a political bargaining chip three months after Congress failed to reauthorize the Children’s Health Insurance Program.
Next week when Congress and President Donald Trump run up against their latest self-imposed government funding deadline, they should reauthorize CHIP for five years, fund it without changes for the remainder of fiscal 2018 and 2019 and stop playing politics with kids’ health care.
Before Christmas, Sen. Orrin Hatch, R-Utah, and Sen. Ron Wyden, D-Oregon, leaders of the Senate Finance Committee, jointly promised to reauthorize CHIP for five years — something that Congress was supposed to do before last Sept. 30. Days before their joint announcement, Hatch had opined that the federal government didn’t have money for CHIP.
The CHIP budget outlook has changed. The new income tax law eliminates the Affordable Care Act penalty for failing to have health insurance. That change will cause private insurance premiums to increase because those who choose to go without insurance will mostly be people who expect to stay healthy, leaving Americans with chronic health problems in the insurance pool.
If CHIP isn’t reauthorized, more parents are expected to enroll their children in private health plans. Premiums for that insurance will increase, boosting the cost of federal government premium subsidies for low- and middle-income families’ children.
The Joint Committee on Taxation and the Congressional Budget Office, the two nonpartisan services that analyze federal spending, have concluded that the insurance market changes set in motion by the new tax law will drastically reduce the marginal cost of reauthorizing CHIP.
In a letter sent last week to Hatch and Wyden, CBO director Keith Hall wrote: “Funding CHIP for five additional years — reducing the number of children covered through the marketplaces — would result in a larger reduction in spending related to the marketplaces than in the prior (October) estimate.”
In October, the CBO estimated that reauthorizing CHIP would add $7.5 billion to the federal deficit over the next 10 years. In the new estimate, CBO and JCT agree that the CHIP bill written by Hatch would add only a tenth of that early estimate ($800,000 million) to the deficit over 10 years because continuation of the children’s program would offset most of the deficit spending caused by higher private insurance premiums.
In other words, CHIP is a much greater bargain because of the tax law’s deficit repercussions. That should make CHIP reauthorization an easy cause for all lawmakers to support.
Montana’s delegation in particular should be CHIP champions for their 24,000 young constituents who will be future voters.
CHIP has been a tremendous help to families who make too much to qualify for Medicaid, but not enough to afford private insurance. Over the past 20 years, many Montana kids have had health coverage through CHIP — even though their parents were uninsured.
Montana voters themselves expanded eligibility for the state’s CHIP program through ballot Initiative 155. As noted by legislative staffer Sue O’Connell in a report prepared for next week’s interim children and families committee meeting, I-155 required that the state coordinate CHIP and Medicaid to the greatest extent possible.
The federal government pays 99 percent of the cost of CHIP for all states after the federal match was boosted in 2010 by the Affordable Care Act, O’Connell wrote. The ACA provides that “enhanced” federal rate is in effect through fiscal 2019.
Just before Christmas, Congress passed a four-week budget bill that included enough money to keep CHIP running in all states through February, maybe into March. It’s time to belatedly reauthorize CHIP on terms that will allow Montana and other states to continue this highly successful program to keep U.S. kids healthy at reasonable cost.
CHIP was created two decades ago by a strong bipartisan partnership in the U.S. Senate. We call on Sen. Jon Tester, Sen. Steve Daines and Rep. Greg Gianforte to lead the bipartisan campaign to reauthorize CHIP now.