Scores of children at risk of losing healthcare coverage

9th October 2017   ·   0 Comments

By Della Hasselle
Contributing Writer

Congress has missed a deadline to reauthorize a federal program designed to provide health coverage for nine million children nationwide.

Federal lawmakers failed to reauthorize the Children’s Health Insurance Program (CHIP), cutting off federal funding that helps states provide lower-income families affordable health insurance for their kids.

CHIP gives funds for families who aren’t eligible for Medicaid.

The program costs roughly $13 billion a year. Of that, nearly $10 billion is paid for the by the federal government, according to the Kaiser Family Foundation.

Every state uses CHIP, which expired Sept. 30, to help give kids health insurance. The program has been in operation since 1997.

Now, the program’s full funding won’t be allocated to the states until Congress renews the bill, although the lapse doesn’t necessarily mean children will be cut off from health insurance right away.

The delay means different things for different states. If states have unspent federal CHIP funding, they can use it until Congress passes a renewal bill.

Louisiana has enough funds to cover the program through the beginning of 2018. Several others are expected to run out of money by the end of this year.

States could start to freeze the program if Congress fails to renew it quickly. Local officials have indicated that could happen in Louisiana.

In a statement, Andrew Tuozzolo, the chief of staff for the Louisiana Department of Health, called Louisiana’s CHIP program a “fundamental element of care” for the state’s underserved children.

Tuozzolo said that LaCHIP covers more than 122,000 children and provides “high-levels” of care and access similar to private insurance.

Because of the program, the state’s rate of uninsured children dropped from 11.1 percent to 3.8 percent between 2003 and 2015, he added, calling the decline “among the lowest in the nation.”

He also underscored that federal mandates require Louisiana to cover eligible children through 2019, regardless of match rates. However, without reauthorization, Louisiana would need to shoulder costs of up to $31 million a year beginning in February.

“With dire budget problems at our doorstep, Louisiana would be hard-pressed to maintain current levels of healthcare access for these vulnerable children,” Tuozzollo said.

If Congress fails to maintain the CHIP program at its current match rate, federal lawmakers will effectively “cripple” the current financing structure of the Louisiana Medicaid program, health officials added.

That, in turn, would lead to reduced access to care when other benefits and services or eligibility groups are cut. Reductions in children’s coverage would result in fewer children accessing preventive services such as child visits and immunizations, according to Louisiana’s health department.

Moreover, the department says CHIP is beneficial to the health of the state, not just individuals. Officials point to a 2007 analysis by the American Academy of Pediatrics, which estimated an annual cost to the community of over $2,100 per child if CHIP coverage is lost.

The increase would be caused by a shift from ambulatory care to emergency departments and an increase in average lengths of stay, officials said.

So far, both the House Energy and Commerce and Senate Finance committees have passed bills to renew CHIP, but it’s unclear how long it will take a renewal bill to make its way through full Congress.

The bipartisan Senate plan, approved in committee Oct. 4, extends funding for CHIP for five years and gradually dwindles a funding increase previously provided under Affordable Care Act.

It also calls for federal CHIP funding to drop by 23 percentage points by 2020. The drop would return funding to its pre-Affordable Care Act levels.

The House plan, backed by Republicans, calls for the same amount of funding but ties it to Medicare by proposing a premium increase for seniors earning more than $500,000 a year to help pay for it. Democrats have opposed that proposal, signaling that the bill could be delayed amid partisan politics.

If passed as is, the bill would extend the life of the CHIP program through 2022.

In a letter to chairmen of the Finance and Energy and Commerce committees, officials with more than 50 health and children’s rights organizations called the program a “national success story” that had in recent years cut the rate of uninsured children “to the lowest level ever recorded.”

The letter was penned last year by the American Academy of Pediatrics, the American Public Health Association, the Children’s Hospital Association, the Children’s Health Fund, the Children’s Defense Fund and several others.

“If CHIP funding is not extended beyond 2017, many CHIP-enrolled children and pregnant women would likely become underinsured or uninsured altogether, which would threaten their access to care and the historic gains made insuring children over the past two decades,” they wrote. “Thanks to the pediatric-appropriate benefits and strong cost-sharing protections in CHIP, our nation has developed a standard of comprehensive, affordable health coverage for children such that children would lose ground if funding for CHIP is not extended.”

Rep. Cedric Richmond and Rep. Steve Scalise did not return requests for comment.

This article originally published in the October 9, 2017 print edition of The Louisiana Weekly newspaper.