Children’s health advocates were encouraged by last week’s announcement that key senators had struck a deal to reauthorize the federal Children’s Health Insurance Program (CHIP) for five years. Unfortunately, Sen. Bill Cassidy’s last-ditch partisan effort to repeal the Affordable Care Act (ACA) is getting in the way of the effort to renew CHIP before its expiration date, which could have devastating consequences for kids.
CHIP is set to expire on Sept. 30, leaving Congress just 10 days to renew the program that provides health coverage to near 9 million children nationwide, including 120,000 in Louisiana. A “clean” reauthorization – which doesn’t use the program as a vehicle to press an unrelated partisan agenda – is critical to ensuring uninterrupted health care for these kids.
Sources: Louisiana Department of Health, July 2017 LaCHIP enrollment; U.S. Census Bureau’s American Community Survey.
Congress created CHIP in 1997 as a bipartisan effort to reduce the number of uninsured children and improve health outcomes by ensuring early and ongoing access to care. The program has worked as intended: The number of children without health insurance has dropped dramatically, and health outcomes have improved. Before CHIP, 15 percent of American children were uninsured (18 percent in Louisiana). By 2015, just 5 percent of children were uninsured. Louisiana did even better, dropping its uninsured rate for children to 4 percent.
Louisiana’s version of the federal Children’s Health Insurance Program – LaCHIP – provides health insurance to 120,000 Louisiana children. That’s more than 1 in 10 – or 10.8 percent – of all children in the state. Rural parishes have some of the highest rates of CHIP enrollment in the state, including: East Feliciana, St. Landry, St. Bernard, and Richland parishes. Jefferson Parish also a high rate of children enrolled in LaCHIP with 13,540 children, or 14.2 percent, of children in the parish receiving health insurance through the program.
LaCHIP serves low-to-moderate income children whose families earn too much to qualify for Medicaid but not enough to afford private insurance. The maximum income a household can have and qualify for LaCHIP is 255 percent of the federal poverty line, which equals $62,700 per year for a family of four. Children enrolled in LaCHIP whose families earn less than 217 percent of the poverty line, or $53,400 for a family of four, can enroll in LaCHIP free of charge. If a family of four earns between $53,400 and $62,700, they are responsible for paying a premium of $50 per month to enroll their children in the program.
LaCHIP is operated by the state but financed with a mix of state and federal dollars. Since CHIP’s inception, the federal government has paid roughly three-quarters of Louisiana’s total program costs, with the state picking up the rest. But for federal fiscal years 2016 through 2019, the ACA raised the minimum federal matching rate for CHIP by 23 percentage points, bringing Louisiana’s CHIP matching rate from 73 percent in fiscal year 2015 to 96 percent in 2016. The tentative deal in the Senate would phase out the increased matching rate for CHIP by 2021, which would give states time to plan for the reduction in federal funding and adjust accordingly.
The momentum to enact a five-year CHIP reauthorization has been interrupted by the rush to pass the disastrous Cassidy-Graham ACA repeal and replace bill. A recent survey by The Kaiser Family Foundation found that without a reauthorization from Congress, 10 states will run out of CHIP funding before the end of the year. Louisiana would exhaust all unspent CHIP funds in early 2018, jeopardizing access to care for 1 in 10 children in the state. Protecting children’s access to health care is one more reason the Senate should move on from this half-baked, partisan effort to repeal the ACA.