In 1993, the late Governor Robert P. Casey Sr. signed the first Children’s Health Insurance Program into law in Pennsylvania, which later served as a model for the federal program Congress would enact a few years later. Westmoreland County’s then State Senator Allen Kukovich was instrumental in enacting this state program that he’s considered its founding father. Since 1997, the Children’s Health Insurance Program has provided matching funds to states for health insurance to children from families who can’t afford marketplace or employer insurance but earn too much to qualify for Medicaid. Sponsored by the late Senator Ted Kennedy in partnership with Senator Orrin Hatch and supported by then First Lady Hillary Rodham Clinton, it was the largest expansion of taxpayer-funded health insurance coverage for children in the United States President Lyndon B. Johnson established Medicaid in 1968. Today CHIP is a critical government program providing health insurance for nearly 9 million low-income kids as well as remains one of our nation’s most vitally important and widely supported programs. Thanks to CHIP, the United States enjoys has the highest rate of insured children in our nation’s history at over 95%.
On September 30, 2017, CHIP expired when lawmakers couldn’t agree on a 5-year reauthorization of the program. This puts millions of kids at risk of becoming uninsured, and in some cases, being denied the critical care they need to survive and thrive. Though states have remaining funds to keep their programs running for varying lengths of time, it’s an administrative nightmare for states that can’t plan ahead. But they may have to prepare for a possible shutdown of their CHIP programs well before they run out of money. As Alabama CHIP director noted, “This whole situation is causing chaos. We are causing confusion to families, stress and turmoil.” On December 15, Alabama officials were forced to announce that they’d stop taking new enrollees on New Year’s Day and the 84,000 kids (1/8 of the state’s children) currently in the program could lose coverage February 1. In my home state of Pennsylvania, the families of 174,000 children currently enrolled in CHIP are about to receive notices informing them that their insurance may be canceled while Colorado already has sent a letter back in September that their CHIP coverage will be canceled by the end of January. Utah has already submitted a request to the federal government to freeze their program’s enrollment. Some states such as Nevada, already have laws that force officials to freeze enrollment if federal funds decrease at all. By the start of 2018, more than half the states are projected to have used up their available funding. Across the country, families depending on CHIP are running out of time.
On December 21, 2017, Congress passed short-term legislation to fund CHIP until the end of March, which is said to cover an estimated 1.9 million children across 24 states and Washington D.C. which stood to lose coverage care like doctor visits and hospitalizations in January. But this temporary relief still leaves CHIP and the families who rely on it in uncertainty since as of December of 2017, there is no long-term fix in sight. As George Washington University professor Sara Rosenbaum told Bloomberg, “You can’t run an insurance program this way.” Essentially, lawmakers are forcing health officials running the program, “to go month-to-month.” Still, even with these short-term fixes, “there will be relief that the funding has been extended, but it will be combined with a lot of anxiety,” as Kaiser Family Foundation executive vice president Diane Rowland claimed.
Health coverage is critical for children to get a healthy start in life and high coverage rates mean more children have an opportunity to meet their potential. It is well understood that covering kids is an investment in our future since a child’s health, school performance, and future success are all linked. So it goes without saying that unhealthy children are at higher risk for school problems, failing, or dropping out. Children who have health insurance through CHIP or Medicaid have better access to healthcare and do better in school than their uninsured counterparts. And better school performance provides a foundation for future success in life. Thus, investing in children’s coverage programs means investing in not only children’s health, but also academic success and success later in life. CHIP is especially important to children with special health needs, children of color, children in working families, and children in rural communities. Without CHIP, there would be more uninsured children, increased healthcare costs and less access for kids with insurance, and great financial devastation for families with special needs kids. At any rate, losing CHIP will devastating to millions of families, which will mean uncertainty surrounding their children’s health, much higher healthcare costs and added financial burdens, for some, a complete loss in their children’s coverage.
There is no question that Congress must vote to continue funding CHIP or else coverage for the 9 million kids whose families depend on CHIP will be in jeopardy. Should federal CHIP funding end, states would need to adjust their budgets, either ending or significantly cutting back on existing CHIP programs. Options available to a state may depend on whether it operates a separate CHIP program or has CHIP as an expanded Medicaid one. Either way, children’s health coverage will suffer. Nevertheless, failing to fund CHIP will undo 20 years of progress as well as undermine our nation’s values. If we want our children to live and succeed in this country, then funding CHIP should be a top priority. As Americans, we have a moral, ethical obligation to take care of our children. But if we can’t protect children’s health insurance, what does it say about our values?