Short-term Government Funding Keeps CHIP Afloat, Barely

Alicia Ault

December 08, 2017

Congress has passed a measure that will keep the federal government funded through December 22 and to make it possible for some states that were running out of money for their Children's Health Insurance Program (CHIP) to keep operating, at least through the end of the year.

But many Democrats voted against the bill (H.J.Res.123), known as a continuing resolution (CR), because it did not offer long-term solutions for many issues, including payments owed to insurers under the Affordable Care Act (ACA) and a more permanent reauthorization of CHIP, which covers 9 million children and 370,000 pregnant women each year.

"I voted no because there are too many things left undone," said House Minority Leader Steny Hoyer (D-MD) in a speech after the bill passed. "I voted no because the American people expect us to get our work done, and not sit and twiddle our thumbs while Rome is burning," he said.

Without the new CR, the government was due to shut down at midnight on December 8. In addition to needing to make that deadline, lawmakers have been scrambling to figure out how to get their priorities included in end-of-year legislation. The CR — typically used to fund government operations instead of an actual budget — is often a vehicle for those priorities.

The House voted 221-193 (with only 14 Democrats in favor, and just 18 Republicans against) to approve the CR, while the Senate voted 81-14 for the bill. It now goes to President Trump, who is expected to sign the legislation.

Small Reprieve for CHIP

The CR included a technical change that will allow the Centers for Medicare & Medicaid Services to funnel funds to state CHIP programs that are due to run out of money at the end of the year. But it did not adopt a 5-year extension of CHIP, which has been approved by the House and backed by medical societies and patient advocates.

A coalition of children's advocacy organizations — including the American Academy of Pediatrics, the Children's Defense Fund, and the Children's Hospital Association — expressed their disappointment to Congress about the short-term fix. "Confidence in the program's future cannot be restored with stopgap measures, and these Congressional delays jeopardize the long-term stability of this lifeline for children," they said. "Congress must act NOW to enact the strong five-year extension of CHIP as supported by both the House and Senate, free of harmful offsets, to avoid compounding the damage already done in states and to children and families," said the organizations.

Frederick Isasi, executive director of Families USA, said that many states will still be trying to figure out how to keep their programs going after the New Year. "Already, Colorado has notified families CHIP will shut down by January 31 if Congress doesn't act," said Isasi in a statement. "In early 2018, families in Pennsylvania, Texas, Utah, Virginia, and Washington may receive similar notices as these states are expected to run out of funds for their programs."

Even Republican lawmakers expressed frustration with the inability to extend CHIP.

"It's frustrating to see states forced to rely on this stopgap funding to pay for CHIP when the House passed a fully funded, five-year extension of this essential program last month," said Energy and Commerce Committee Chairman Greg Walden (R-OR) and Health Subcommittee Chairman Michael C. Burgess, MD (R-TX) in a statement. "In the meantime, bipartisan, bicameral discussions continue so we can swiftly reach an agreement on a broad package to extend funding for CHIP, Medicare extenders that seniors rely on, and other vital public health programs. Patients have been waiting for far too long. We need to get this done."

Fight Begins Anew December 18

Lawmakers will have another chance to reauthorize CHIP before the end of the year, as they will have to vote again on a short-term funding bill or a permanent budget bill before December 22.

In addition to the CHIP extension, Democrats said they are still looking to get a permanent legislative solution for undocumented immigrant children who have been admitted into the United States under the Deferred Action for Childhood Arrivals (DACA) program. That program expires in March.

Democratic lawmakers are also hoping to increase funding to combat the opioid epidemic and to secure payments to insurers — known as cost-sharing subsidies — to cover low-income ACA enrollees.

Conservative Republicans, however, vowed that neither the DACA fix nor continued cost-sharing payments would be included in the next spending bill, according to multiple media reports..

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