Both the House and Senate have introduced bills to extend the Children's Health Insurance Program (CHIP), now scheduled to expire Sept. 30.
That legislative momentum also got some powerful backing Thursday when the New York Times posted an op-ed co-authored by Hillary Clinton and former Senate Republican leader Bill Frist in which they also pushed for extension of the CHIP program.
The piece reflects the mood on Capitol Hill. “Politically, this isn't the Affordable Care Act all over—there's no real disagreement that the program is needed and worthwhile,” said John Rother, president and CEO of National Coalition on Health Care (NCHC), and former Republican Senate staffer. “CHIP renewal has bipartisan support in general—Clinton and Frist reinforce that.”
However, neither the Senate's Protecting & Retaining Our Children's Health Insurance Program Act of 2015 nor the House's CHIP Extension and Improvement Act of 2015 have Republican backers, despite Rother's assertion.
The Senate bill does have the support of Sens. Angus King (I-ME) and Bernie Sanders (I-VT). Both bills would extend CHIP funding through 2019.
The lack of Republican backing may have more to do with timing than commitment, according to Joseph Antos, a healthcare economist with the conservative American Enterprise Institute.
“It's because it's too early, the thing doesn't expire until the end of September,” Antos said. “I don't think anyone doesn't want to extend CHIP. Republicans may need some leverage later on to get a bill passed.”
CHIP has been around for nearly two decades. Should it end, approximately two million children would lose access to healthcare, and more than eight million children could lose access to specialty care, because not all physicians who accept CHIP also accept Medicaid, which is where many children would go should the program expire, according to an analysis by former Sen. Jay Rockefeller (D-WV). Rockefeller introduced a bill to extend CHIP before he retired last year.
There are further consequences that could result from a failure to extend CHIP, said Vijay Das, a healthcare policy advocate at Public Citizen, a patient advocacy organization.
Under the ACA, employers need to provide insurance for workers but not workers' families. As a result, the so-called “family glitch” becomes an issue, Das said. “Although premiums paid by workers are capped, there is no limit on the employee's share of premiums for family members, and these often cost three times as much as an individual's coverage,” he said.
CHIP is for children in families earning up to 200% of the poverty level. Federal spending for the program was $13 billion in fiscal year 2013, up 8% from the previous year.
Since the Congressional Budget Office has yet to score the Senate bill, its potential financial impact is unknown, and no pay-for has been discussed, according to a Senate spokeswoman. However, she did point to a provision in President Barack Obama's 2016 budget which said an extension could be funded by increasing the tobacco tax. Requests for comment from the House were not returned.