Children's Health Insurance Program
Without Congressional action, funding for the Children’s Health Insurance Program (CHIP) will expire at the end of federal fiscal year 2015 (September 30, 2015), although the program is authorized through September 30, 2019. Since its bipartisan beginnings in 1997, CHIP has been an essential source of high-quality coverage for children and families whose incomes place them above the Medicaid threshold but who do not have access to employer-sponsored or private insurance. CHIP provides health insurance to over 8 million children nationwide, and has helped reduce the number of uninsured children by more than 50 percent, from 14% in 1997 to just 7% in 2012. CHIP requires states to cover regular check-ups, immunizations, hospital care, dental care and lab and X-ray services.
There is legislation in both the House (H.R. 5364) and the Senate (S. 2461) to extend CHIP funding through 2019 and to make other improvements to the program, including extension and expansion of the pediatric quality measurement and improvement programs that have become hallmarks of CHIP. A four-year funding extension, which would align program funding with program authorization, would also give the federal government and states the time needed to assess where and how the Children’s Health Insurance Program fits into the new Affordable Care Act-based health care marketplace.
Congress Should Fund CHIP Through FFY 2019
ACAP has a strong record of supporting the expansion of Medicaid and CHIP to ensure that lower-income Americans have access to high-value public insurance. CHIP has played a vital role for children and pregnant women in this country for nearly two decades, and its ongoing funding is crucial to ensure these gains are not lost. ACAP recognizes that it may be appropriate for some aspects of the current CHIP program to be transitioned into the health care marketplace in the future; this is not, however, the time to make such changes:
- There is insufficient information about how the marketplaces would meet the health care needs of the children and pregnant women currently eligible for CHIP;
- Solutions would need to be found to address the fact that, without the CHIP program, many children would become uninsured as a result of no longer having access to affordable coverage; and
- The marketplaces need to be able to stabilize before being required to accommodate another major change in health care program structure and financing.
Specifically, ACAP calls on Congress to include a four-year CHIP funding extension in the next legislative vehicle that is moving during the 113th Congress. Families need to know that their children will be able to continue to have access to high-quality health care without disruption. Addressing CHIP funding now will ensure that states, families, and health plans will have sufficient time to plan and ensure that such coverage disruptions will not occur. There is significant evidence that gaps in coverage lead to adverse clinical outcomes and higher medical costs when individuals regain coverage. Moreover, such “churning” – both within and among types of insurance – disrupts quality measurement and improvement.
The 113th Congress can take action this year to minimize such disruptions by enacting a four-year funding extension now. CHIP, and the health plans and providers that participate in the program, have invested significant resources in such programs with great results. This work must not be abandoned.