How CHIP could turn into a Repub­li­can bar­gain­ing chip

Modern Healthcare - - THE WEEK AHEAD - —Vir­gil Dick­son

A Se­nate com­mit­tee on Tues­day will con­sider the ex­ten­sion of the Chil­dren’s Health In­surance Pro­gram, whose fund­ing is sched­uled to ex­pire next Septem­ber.

CHIP, which cov­ers chil­dren in fam­i­lies earn­ing up to 200% of poverty, has sub­stan­tially ex­panded chil­dren’s cov­er­age since its cre­ation in 1997 and long has en­joyed bi­par­ti­san support.

Re­tir­ing Sen. Jay Rock­e­feller (D-W.Va.), chair of the Se­nate Fi­nance Com­mit­tee’s health­care panel, said that if CHIP ends, about 2 mil­lion chil­dren will lose ac­cess to health­care al­to­gether and more than 8 mil­lion may lose ac­cess to spe­cialty care. Fed­eral spend­ing for CHIP was $13 bil­lion in fis­cal 2013, up 8% from the pre­vi­ous year.

The fed­eral Med­i­caid and CHIP com­mis­sion has urged a two-year ex­ten­sion to al­low a smooth tran­si­tion of chil­dren into health plans sold on the Oba­macare ex­changes. Rock­e­feller has in­tro­duced a bill to ex­tend CHIP through 2019, of­fer­ing states ex­tra in­cen­tives to strengthen their pro­grams. In July, a bi­par­ti­san group of House and Se­nate lead­ers sent a let­ter to gover­nors ask­ing for in­put on the is­sue.

Yev­geniy Fey­man, a fel­low at the Man­hat­tan In­sti­tute, a con­ser­va­tive think tank, pre­dicted Repub­li­cans will try to use the pro­gram’s ex­ten­sion as a bar­gain­ing chip to win support for turn­ing Med­i­caid into a state block grant pro­gram.

Devon Her­rick, se­nior fel­low at the con­ser­va­tive Na­tional Cen­ter for Pol­icy Anal­y­sis, said it may be hard for Repub­li­cans to push for end­ing the pro­gram given that many GOP-led states have not ex­panded Med­i­caid, mean­ing many chil­dren in those states would fall into a cov­er­age black hole. “My sense is there will be po­lit­i­cal pres­sure to con­tinue fund­ing after 2015,” he said.


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