As readers of Say Ahhh! know, the Children’s Health Insurance Program (CHIP) is running out of money next year and must be extended by Congress. That means public coverage for children will be squarely on the Congressional agenda. There are many different ways the Republican majority could go on CHIP, and it’s very hard to say which direction they will take. But if history is any guide, we can expect that they will push for less federal money going in and more state flexibility, which translates to fewer protections for children.
But the future of CHIP is wrapped up with larger health policy questions such as whether the ACA is repealed and the fundamental question of what will be on the table for CHIP’s big sister – the Medicaid program.
Everybody knows the President-elect Trump campaigned on a promise to repeal the Affordable Care Act, but few are aware that he also talked about block-granting Medicaid. Block-granting Medicaid is a radical proposal that could imperil coverage for millions of kids and families – depending on the size of the cuts and the loosening of federal guarantees of coverage, benefits, and cost-sharing that currently exist.
I was involved in the block grant debate twenty years ago when Speaker Newt Gingrich led the House of Representatives. Interestingly, the Congressional debate has moved away from block granting to more of a discussion of a per capita cap for those who want to make major structural changes to the Medicaid program. In future blogs we will explain more of what these two concepts are and how they differ. But for now, I will just say both would likely be extremely harmful for low-income children and families.
Today Medicaid covers 37 million children. Few are aware of how important Medicaid is to children. (See our factsheet on Medicaid’s role for children.)
As readers of SayAhhh! Know, we have reached historic levels of coverage for children (95% of kids were covered in 2015) thanks to the good work of Medicaid, CHIP and the ACA. Whether we continue down this path or make a U-turn remains to be seen. But it is clear that tough times lie ahead.
Here at CCF we plan to keep working hard to ensure that all children and their families have access to quality affordable health coverage.