How CHIP could turn into a Republican bargaining chip

A Senate committee on Tuesday will consider the extension of the Children's Health Insurance Program, whose funding is scheduled to expire next September. CHIP, which covers children in families earning up to 200% of poverty, has substantially expanded children's coverage since its creation in 1997 and long has enjoyed bipartisan support.

Retiring Sen. Jay Rockefeller (D-W.Va.), chair of the Senate Finance Committee's healthcare panel, said that if CHIP ends, about 2 million children will lose access to healthcare altogether and more than 8 million may lose access to specialty care. Federal spending for CHIP was $13 billion in fiscal 2013, up 8% from the previous year.

The federal Medicaid and CHIP commission has urged a two-year extension to allow a smooth transition of children into health plans sold on the Obamacare exchanges. Rockefeller has introduced a bill to extend CHIP through 2019, offering states extra incentives to strengthen their programs. In July, a bipartisan group of House and Senate leaders sent a letter to governors asking for input on the issue.

Yevgeniy Feyman, a fellow at the Manhattan Institute, a conservative think tank, predicted Republicans will try to use the program's extension as a bargaining chip to win support for turning Medicaid into a state block grant program.

Devon Herrick, senior fellow at the conservative National Center for Policy Analysis, said it may be hard for Republicans to push for ending the program given that many GOP-led states have not expanded Medicaid, meaning many children in those states would fall into a coverage black hole. “My sense is there will be political pressure to continue funding after 2015,” he said.

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