Republicans are talking incessantly about the need to “fix” the Affordable Care Act (ACT) or “Obamacare” by the end of 2017. The ACA was coined “Obamacare” as a fallacious argument covering for a right-wing conservative agenda to hide changes to redistribution of health care costs. Most of those involved in the passage of the ACA and the public remember that the ACA was passed after considerable negotiation.
While the GOP is trying to keep you focused on pushing their agenda, there is real imminent danger if the Child Health Insurance Program (CHIP) expires which could put millions of children and pregnant women off healthcare. CHIP is a federal and state program that currently covers about 9 million children and pregnant women who do not qualify for Medicaid but whose income is below the federal poverty line. If CHIP isn’t reauthorized, ten states will run out of money including Utah, the home state of Orrin Hatch, the Chairman of the Senate committee for the CHIP program. If CHIP expires at the end of 2017, five states will be forced to whittle down their program and 21 more states are likely to run out money in the first quarter of 2018 (see Figure 1).
Figure 1. State projections of dates of federal CHIP fund exhaustion as of summer of 2017. Courtesy of the Kaiser Foundation.
Some states, like New Hampshire, cover these people through Medicaid Expansion, however, there is a sunset provision that will end that program, if not extended, in December of 2018. If Medicaid Expansion is not extended in 2018, about 50,000 granite-staters, who earn less than 138% of the federal poverty level, will lose their health care at the end of 2018.
In New Hampshire, we are fortunate that Senator Hassan and Rep. Kuster are talking about what would happen if CHIP isn’t reauthorized. Enhanced federal matches ended on July 1, 2017 and failure to reauthorize CHIP would further downshift costs to the state. Without CHIP, children and pregnant women would suffer from short-term and long-term health care instability. This will leave some who have chronic illness or cancer caught in a predicament of whether to seek and receive much needed medical care or pay the rent or buy healthy food.
Figure 2. Uninsured rates among nonelderly adults and children 1997–2016. Courtesy of the Kaiser Foundation.
According to the Kaiser Foundation, the CHIP program has been successful in reducing uninsured rates for children to a historical low of 5% (see Figure 2) and non-elderly, most likely pregnant women, to 12%. Historically, when enrollment in CHIP was capped or frozen parents reported that they had difficulty obtaining prescription medicines for their children and reported problems accessing medical care for their children which resulted in significant financial hardships that required them to cut back on necessities, borrow money from friends or family, and acquire debt for missed bill payments.
Several controversial attempts to reauthorize CHIP have stalled progress. These include last-minute attempts to pass the Graham-Cassidy bill and entangling it with disaster relief to Puerto Rico. As time goes on, the possibility of a child healthcare crisis grows, yet elected officials are generally not talking about it. Elected officials have to reach across the aisle and engage people like Senator Susan Collins of Maine to reauthorize CHIP before children go without needed medical care. Constituents need to engage their elected officials and let them know that CHIP must be reauthorized and not undermined.