Health Care for Children Shouldn’t be a Bargaining CHIP
November 28, 2017 01:38 pm
When I ran for governor in 2000, my Republican opponent and I had much to disagree on. But when it came to the federally-supported Children’s Health Insurance Program (CHIP), we only sparred over who would implement coverage more aggressively, not over the merits. Almost all policymakers recognize the importance of this bipartisan legislation enacted in 1997 in reducing the percentage of uninsured children from almost 14 percent to less than 5 percent.
As president of the Alliance for Excellent Education, I usually focus on education issues, but CHIP is both personal and related. Personal because I have seen how it extended coverage to the children of hard-working families who were just over the Medicaid eligibility criteria but could not afford health insurance. It is education-related because healthy children have much better ability to learn than ones in discomfort or ill. Ask any teacher.
So why did Congress permit funding to expire September 30 despite the uncertainty it creates for most states and millions of parents? And despite the many congressional pledges to renew it soon, what do we need to do to make sure this occurs before January 1—and without holding children’s health care hostage to the esoteric budget “scoring” and appropriations tradeoffs that will be taking place during the upcoming tax bill and budget processes?
My congressional experience taught me not to be surprised at seeming failures to take necessary action. Often there is a reason obscured in the arcane legislative process. Perhaps congressional leadership is holding a popular “must-renew” bill to vote on at the same time as some unpopular votes are taken. Or the almost $14 billion price tag (the federal government pays about three-fourths of this) may be held to use in budget scoring. Or some congressional tactician thinks this is a good legislative hostage to encourage favorable action in other bills. Or, perhaps none of the above. Maybe just pure congressional dysfunction due to partisan intransigence on other legislation. I did not have to serve long in Congress to learn that when a program has wide bipartisan support and draws no political fire, then vote on it right away and not risk losing it to totally unrelated factors.
While there may be perfectly logical reasons stated under the national Capitol dome, my congressional experience also taught me there are times the public must simply demand, “Get it done.” Nine million children and 370,000 pregnant women are covered by CHIP. Eleven states essentially run out of money by January 1; twenty-one more by April. This is not just a bureaucratic problem in every state capital. State leaders and millions of parents are now having to make critical health care decisions.
An analysis by the Georgetown University Health Policy Institute has noted that any delays in CHIP funding “create unnecessary chaos and confusion for states and families,” adding that, even if Congress eventually funds CHIP, “children are likely to fall through the cracks due to the uncertainty caused by the delay in funding.”
The popular Beltway wisdom is that both houses will take this up shortly after returning from Thanksgiving. Sounds reasonable. But recent experience shows there will be much legislative high drama in the next few weeks before Congress goes home for the holiday season. The controversial tax bill. The need to renew overall spending and the debt limit that expires on December 8. More disaster relief. Protecting Dreamers. The run up to the New Year will be full of legislative distraction and noise.
We need to cut through the upcoming congressional cacophony. Which is why now is the time to have a clear and determined message: Pass a “clean” CHIP now. “Clean” means without massive changes, such as taking other health care dollars to pay for CHIP.
This means every organization should be immediately contacting members of Congress. So should all of us as individuals. And while most representatives and senators will respond they support CHIP and are working on renewal, a massive communications push provides extra impetus for getting the job done. The most senior congressional leaders still must listen to the most junior members, especially when they are seeking votes on much more controversial measures.
This should be an easy vote for Congress. Particularly if they hear the clear message: Pass a clean CHIP before you come home for the holidays.
Bob Wise is the president of the Alliance for Excellent Education, a former governor of West Virginia, and a nine-term member of the U.S. House of Representatives.