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66 days later: Why hasn’t Congress renewed health insurance for millions of children?

CHIP serves our most vulnerable children—and Congress let it expire months ago.


Brenden Gallagher

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Posted on Dec 6, 2017   Updated on May 22, 2021, 8:55 am CDT

With the fiscal bloodbath of the Republican tax proposal, and looming cuts to programs like Medicare and Social Security, another assault on the working class has been largely left out of the conversation. CHIP, the Children’s Health Insurance Program that offers low-cost coverage to children whose families earn too much to qualify for Medicaid, has not been renewed by Congress. It expired 67 days ago, on Sept. 30.

While some pundits have painted this as a result of government incompetence, the politics of the tax plan make it clear that this isn’t a bug, but a feature of the Republican agenda. The GOP is willing to let poor people die in exchange for tax breaks on luxuries and a reduced estate tax—and those dying people include children.

Until recently, CHIP enjoyed bipartisan support. Even if Tea Party Republicans were ideologically opposed, CHIP just works too well. For the relatively small annual output of $15 billion, the uninsured rate among children dropped from 14 percent to 5 percent in the two decades that CHIP has been in existence. The combination of CHIP and Medicaid provide healthcare to one in three American children today.

Studies have shown that CHIP is more popular with its beneficiaries than employer-provided health insurance and it’s easy to see why. It not only tugs at our collective heartstrings by giving tiny humans the right to healthcare, it also works efficiently for impoverished communities, communities of color, and other marginalized groups. 9 million children and pregnant women across the country depend on CHIP benefits, and many states will be left unable to provide healthcare for their most vulnerable citizens if CHIP goes away.

What sort of services does CHIP provide? Essentially, the program functions as health insurance for children and pregnant women who can’t afford it. This includes routine checkups, immunizations, prescriptions, hospital care, X-rays, emergency services, and more. And, the program is relatively simple when compared to the Affordable Care Act (ACA): Doctor and dental visits are free; the total out-of-pocket cost of care cannot exceed more than 5 percent of a family’s income.

A favorite argument of conservatives is that citizens are looking for government handouts. CHIP is built to fight this (statistically incorrect) notion. CHIP funds are reserved for those who already make more than enough to qualify for Medicaid. It fills the gap between those who qualify for government-provided healthcare and those who purchase healthcare through their employer or on exchanges. CHIP covers families making between 200 percent and 300 percent of poverty level depending on the state. That being said, CHIP recipients also demonstrate need. For example, a family of three making $40,000 a year would qualify for the program. So CHIP provides a bit of economic stability and flexibility for families that are already working by freeing up often-prohibitive healthcare costs. Additionally, children with insurance have better health and educational outcomes later in life.

Like most cuts made by Republicans and our current GOP-led Congress, CHIP’s expiration disproportionately affects women. 24 percent of CHIP and Medicaid households are run by a single-female parent, and as you might guess, 23 percent of American children live with their mother in a single-parent household compared to just 4 percent of children living with only their father.

Minority communities are also greatly served by the benefits of CHIP. A comprehensive study of the program from 2014 found that over half of Black and Hispanic children are on Medicaid or CHIP; 60 percent of CHIP recipients are Black or Hispanic. A study conducted in New York state found that “enrollment in CHIP almost eliminates racial and ethnic health disparities across multiple measures related to access, unmet need, and continuity of care.”

The program also protects children with special needs. That 5 percent income cap on a family’s coverage spending prevents parents from going bankrupt because of their child’s medical needs. If CHIP is not renewed, there are American families who would go from paying nothing to paying tens of thousands of dollars annually to deal with a non-preventive issue their child faces—whether that is difficulty hearing, autism, or a degenerative disease. All state CHIP programs cover “physical, occupational, and speech and language therapies, often without limits.”

These statistics don’t live in a vacuum, either. Philadelphia doctor Dorothy R. Novick offered some compelling real-world anecdotes about the kinds of patients she sees on CHIP and how they depend on the program in an op-ed for the Washington Post:

“Consider my patient who grew up in foster care, put herself through college and now earns a living as a freelance clothing designer. She is now a mother herself, and I treat her children. Her 1-year-old son has asthma and her 3-year-old daughter has a peanut allergy. The are able to follow up with me every three months and keep a ready supply of lifesaving medications because they qualify for CHIP,” she says.

“Or consider the dad with a hearing impairment whose wife passed away two years ago. He supports his teenage daughters by working as a line cook during the day and a parking attendant at night. He sends the girls to parochial school. He lost their Medicaid when he was given extra house at his restaurant last year. But I still see them because they qualify for CHIP.”

Healthcare is a human right. But with Republican refusal to fund CHIP, we see that not only does the GOP not believe in that right, they don’t even believe in their own dogma to protect families and children. It’s hard to imagine who would meet Republicans’ so-called standards of personal responsibility more clearly than working parents. And still, they want to end this vital program because it doesn’t affect their own bottom line even if it affects their constituents’.

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*First Published: Dec 6, 2017, 6:30 am CST