While Congress members were focused on legislation to repeal the Affordable Care Act (ACA) and cut Medicaid, they irresponsibly let federal funding for the Children’s Health Insurance Program (CHIP) expire on September 30. Texas and other states are keeping the program going right now using existing funds, but those will only last for a few months. Several states have already laid out plans for stopping enrollment and/or shutting the CHIP program down, some as soon as November.
Congress’ inaction is a real threat for children’s access to needed health care, and the degree of harm inflicted increases each week Congress fails to reauthorize CHIP.
While some Congress members have started moving legislation to fund CHIP, a prominent House bill includes controversial proposals to offset the costs of extending CHIP funding, suggesting they may not be truly committed to quick CHIP renewal. The U.S. Senate has not revealed its funding plans. The worst House proposal is the repeal of special rules that have ensured that doctors and other providers delivering prenatal or pediatric care are paid promptly in situations where the patient has both Medicaid and another “third party” (e.g., a private) coverage. This includes cases where there is a medical child support order in effect, and it prevents the medical provider from having to pursue the private insurer for payment. Without this policy in place, more providers of child and prenatal health care may stop accepting Medicaid patients, and those who do accept it may delay care while they chase payments from the private insurer.
The Clock is Ticking: Coverage for over 399,000 Texas Kids Is at Stake
Our Texas CHIP coverage program was created with bipartisan support by the 1999 Texas Legislature, and started covering kids in May 2000. The program serves children in households who earn just slightly too much to qualify for Children’s Medicaid. To qualify, for example, a child in a family of three earning $31,000 before taxes is ineligible for Medicaid, but can get Texas CHIP coverage.
Here are numbers for Texas as of June 2017:*
- In Texas, Medicaid and CHIP combined today cover about 45 percent of Texas kids (3.4 million out of 7.3 million children).
- Over 3.1 million Texas children are covered in Medicaid, and
- Another 399,000 children who are not eligible for Medicaid, but lack access to affordable health coverage, get health care in CHIP.
- In addition, about 36,000 Texas women received prenatal care and post-delivery check-ups with CHIP funds in June, and
- Around 249,000 children in Texas Medicaid were covered under the more generous federal CHIP match rate, which reimburses the Texas budget for over 92 cents for each dollar of care provided in 2017 (92.33 cents in 2017).
- Texas’ 2018-2019 state budget assumes $3.2 billion in federal CHIP funds. If Congress does not act, this will tear a hole in the state budget.
If Congress fails to fund CHIP soon, Texas will be forced to join other states in planning how to shut CHIP down. This means kids going without care, expectant moms going without prenatal care, poorer birth outcomes, and low-income families struggling even harder to meet basic needs. Not to mention the big hole in Texas’ budget.
For more information, take a look at:
* Note: Texas Medicaid-CHIP enrollment is typically reported on a monthly basis. However, some national sources may report the number of “ever-enrolled” children in a year, meaning they would include a child even if only enrolled for one month out of 12. Naturally, these annual numbers are higher than for a monthly enrollment snapshot. You can see Texas’ ever-enrolled annual numbers here.