Uncertainty in Congress envelopes children’s health care program

The U.S. Capitol in Washington is seen June 7. Republicans' effort to pass a health care bill in the Senate collapsed July 17. (CNS photo/Tyler Orsburn) See SENATE-HEALTH-CARE-REACT July 18, 2017.

WASHINGTON–A health program that serves children from low-income families that has enjoyed bipartisan support for 20 years faces an uncertain future unless Congress adopts legislation reauthorizing it before funding runs out in the coming months.

Congress failed to meet a Sept. 30 deadline to continue the federally funded and state-run Children’s Health Insurance Program, or CHIP. Several states were preparing in late November to notify families that the program would end unless the federal government recommits to funding it.

“We’re getting perilously close to seeing states having to take action in one way or another,” Tricia Brooks, senior fellow at the Center for Children and Families and Georgetown University’s Health Policy Institute, said Nov. 29.

“What’s happening with CHIP is unprecedented. We’ve never had a lapse of funding of this sort,” Brooks told Catholic News Service.

Nationwide, about 9 million children are enrolled in CHIP. They come from families with incomes too high to be eligible for Medicaid, but too low to be able to afford health insurance.

Further, CHIP supporters said, the program has worked as intended, reducing the number of children without access to health care from 15 percent in 1997 to 4.8 percent in 2016.

Brooks said the program has continued to operate with funds carried over from fiscal year 2017. The federal Center for Medicaid and CHIP Services also has distributed unused money from earlier years to the states, “but that cushion is wearing desperately thin now,” she said.

Bishop Frank J. Dewane, chairman of the U.S. bishops’ Committee on Domestic Justice and Human Development, and officials at Catholic Charities USA have urged Congress to reauthorize CHIP since the deadline passed.

Brooks along with the center’s Joan Alker and Karina Wagnerman, wrote a report in October that said at least six jurisdictions — Arizona, California, the District of Columbia, Minnesota, Ohio and Oregon — predicted they would run out of money for CHIP by the end of the year. And at least six other states — Colorado, Pennsylvania, Texas, Utah, Virginia and Washington — have said they will notify families before Dec. 31 that their programs face a shutdown even if funding has not yet run out.

Predicting when states will run out of money is a “moving target” because of variables that can change at any time, Brooks said.

Congress has primarily focused on enacting tax cut legislation since the new fiscal year started Oct. 1, much to the chagrin of CHIP advocates. Social workers have said the program, enacted in 1997 in a bipartisan effort and renewed repeatedly since then, is vital to low-income working families.

The press secretary for the Senate Finance Committee said CHIP “continues to be a top priority” for Sen. Orrin Hatch, R-Utah, committee chairman. Hatch wrote the original bill establishing CHIP with the late Sen. Ted Kennedy, D-Massachusetts.

“The Senate Finance Committee reported out a bipartisan bill that would extend funding for five years,” Katie Niederee, the committee’s press secretary, wrote in an email to CNS. “The chairman is continuing to make progress in his discussions on how best to address this issue on the Senate floor and remains confident this will be resolved before the year’s end.”

The House also has considered similar legislation, but no formal vote has been taken. The differences in the bills largely come down to how to pay for the program.

Based on the Senate and House actions, observers expect Congress will include CHIP reauthorization in budget legislation that will be taken up soon after a final vote on the Tax Cuts and Jobs Act, perhaps as soon as Dec. 1. Even so, the reauthorization remained uncertain as Congress raced toward a Dec. 8 deadline to pass even more pressing legislation to fund the government through Sept. 30, 2018, and prevent a pre-Christmas shutdown.

The December deadline was included in legislation signed Sept. 8 by President Donald Trump that raised the debt ceiling and kept the government operating for three months.

CHIP’s unknown future concerns several Catholic organizations that focus on the needs of children, the poor and other vulnerable people. The USCCB, Catholic Health Association and Catholic Charities USA have spent hours on Capitol Hill advocating for the program

“There’s no valid excuse on earth to take care away from children,” Sister Carol Keehan, a Daughter of Charity and president and CEO of the Catholic Health Association, told CNS.

“It has been one of the programs where the money spent has accomplished what it intended to accomplish. This is nothing but an obvious winner for the children of this country. Not keeping this going at a time when many of the other safeguards are going away would just be catastrophic,” she said.

“This is a far higher priority than many of the other things (Congress) is working on,” Sister Keehan added. “They should get it fixed. It’s not that complicated, but it is incredibly important.”

At Catholic Charities USA, Lucas Swanepoel, senior director of government affairs, suggested a program that works well in promoting children’s health ought to “bring us together.”

Expressing confidence that congressional leaders will pave the way for reauthorization, Swanepoel cautioned that hurdles “that have nothing to do with CHIP” still must be overcome to reconcile the House and Senate bills that are expected to become part of the budget legislation.

The U.S. Conference of Catholic Bishops weighed in early on the need for CHIP. In an Oct. 4 letter to members of Congress, days after funding for the program ended, Bishop Dewane said reauthorization “is essential for the good of our nation’s children.”

Citing the words of Pope Francis, the bishop reminded Congress that health care is a human right, rather than a “consumer good.”

“This is especially true for CHIP,” he wrote, “which ensures that all families can provide their children with the health care that they need to grow and flourish.”

By Dennis Sadowski / Catholic News Service

CNS photo/Tyler Orsburn: The U.S. Capitol in Washington.