| Today's Managing Health Care Costs Number is 8.9 million |
This is the Congressional imperative that we just don't hear enough about. Sure, there is the debt ceiling to keep us from defaulting on our national obligations, and the budget to keep us from a government shutdown. And we definitely need to provide relief for the victims of Hurricanes Harvey and Irma.
But we don't hear nearly enough about the Children's Health Insurance Program, CHIP, which provides coverage for 8.9 million kids. Its authorization is up at the end of this month, and states will start running out of resources for CHIP by December. CHIP was co-authored by Orrin Hatch and has earned wide bipartisan support in its past reauthorizations - but Washington is strangely silent on this program.
CHIP was initially created after the failure of "HillaryCare" in the later Clinton administration; since its initiation, the rate of uninsurance among children has declined from 13.9% to 4.5%.
The Trump Budget proposed a 2 year extension of CHIP - but would have cut federal subsidies by 38% ($16.7 to 12 billion from FY 2017 to FY 2018). Clearly - you can't provide coverage for the same number of kids with over 1/3 less funds.
It's a no-brainer to reauthorize CHIP, without the Trump-recommended draconian cuts. When states had greater discretion to exclude children from the program (before the Affordable Care Act increased funding in 2010) often offered little access; in Arizona, the waiting list for CHIP was 5 years long! Some "blue" states would be likely to move children to Medicaid (where federal expense would be the same or higher, assuming that the Republican Congress does not change Medicaid to block grants). "Red" states would either leave children uninsured or move them to exchange plans. These have high deductibles and aren't appropriate for families with few resources.
Children are inexpensive to insure (yes - less than $2000 per insured!) Better access to medical care in childhood can lead to better health for a lifetime. The CHIP population can benefit from the two medical interventions that actually save money (childhood immunization and birth control). An no one can "blame" kids for their poverty.
For those who want universal access to health care - we should guarantee it first for kids. For those who want to be most cost-effective, we should purchase health care for kids using a Medicaid fee schedule. For those who want to have states control most policy decisions - CHIP is a program that allows substantial differences from state to state.
I'm hopeful that CHIP reauthorization will be attached to a must-pass bill that does not include a poison pill - one so that Republicans and Democrats can both endorse. I'm worried the clock is running out.
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