Late this evening, the Senate passed H.R.2, the compromise SGR-CHIP package passed by the House late last month, by an overwhelmingly strong vote (92-8). Most of the health policy world will be buzzing about the fact that this historic bipartisan achievement makes the SGR “doc fix” permanent, and that’s indeed a grand feat.
But this package also extends CHIP for two additional years without any structural changes or rollbacks. It leaves intact the ACA’s coverage improvements, including the requirement that states keep children’s coverage stable through 2019. It extends outreach and enrollment grants. It extends funds for CHIPRA quality measures and demonstration grants. It also extends funding for home visiting programs, family-to-family information centers, and community health centers. And it does all of these things—and even more!— without damaging cuts to Medicaid or the ACA.
(For more detail on what’s in the package itself, see our earlier blog post).
Think back: A year ago we were concerned with making the case that CHIP funding must be extended at all. We knew kids would be worse off without it: the family glitch would block many families benefitting from CHIP from financial support to purchase marketplace coverage and, by the way, that marketplace coverage even when available is not sufficient for kids, particularly by Medicaid/CHIP standards. But that’s all A LOT to get across in an already complex world of health policy. So the child health community came together—bringing new data and research, family stories, and LOTS of education and A-game advocacy from all across the country— to tell the story about what was at stake without CHIP: for the nation’s success covering kids, for state budgets, but most importantly for kids themselves.
This agreement—a bi-partisan, clean CHIP extension— was never a given, even though we knew that kids would be worse off otherwise. Is it perfect? No—a longer extension would be preferable, and 50 senators agreed with an attempt to amend HR2 to do just that by adding the PRO-CHIP bill language first introduced back in February. But recall that not even two months ago we were all staring at another CHIP proposal that would have extended CHIP, but with damaging changes to the structure of children’s coverage that would have threatened its very success. This clean package came together thanks to the dedication, smarts, and collaboration among so many diverse players in the child health community in their relentless dedication to children’s coverage.
The work is not done. But make no mistake: This is a victory for kids and families. Tonight we celebrate.