The Congressional budget process appears to be in a fair amount of chaos with Senate and House Republicans at risk of failing to agree with each other even on a Budget Resolution. While that is not surprising — given the state of disarray in Congress — I was surprised to see that the House Energy and Commerce Committee is moving rapidly to mark up a bill tomorrow that includes cuts to the popular Children’s Health Insurance Program (CHIP).
The bill includes cuts to Medicaid, restricts states’ ability to finance their Medicaid programs through provider taxes and attempts to cut the Prevention and Public Health Fund authorized by the Affordable Care Act. Many of these ideas have been trotted out before and failed. What is new this time is an attempt to cut CHIP funding by eliminating the enhanced match rate (aka “CHIP bump”) that was affirmed just last year in a rare moment of strong bipartisan support when the Medicare Access and CHIP Reauthorization Act (MACRA) passed. The CHIP bump increased the federal share of the costs by 23 percentage points across the board – the enhanced match rate for CHIP now ranges from 88% to 100%. You can read more about MACRA in our summary of the law here.
As I just blogged about Friday, last week we saw some exciting victories for lawfully residing immigrant kids in Florida and Utah, and the bump was a huge factor in making this happen. The bump has also breathed life into an active debate in Arizona about reopening their CHIP program. (Arizona is the only state in the country without an active CHIP program.)
Florida, Utah and Arizona are all states with Republicans controlling all three branches of government. Despite bitter fights within the Republican Party over Medicaid expansion for adults in Florida and Utah, these same Republican lawmakers were able to come together and do right by kids.
It is unlikely that Congressional Republicans will be able to come to agreement on a new budget proposal to send to the President, and even less likely that he would sign it, so I don’t expect that we will see a reduction in the CHIP match rate this year.
However, it is troubling that this proposal is even in the mix – when the same members of Congress voted just last year to extend CHIP with the bump. The U.S. has made incredible, bipartisan progress on reducing the percent of uninsured kids to its lowest level. Florida and Utah legislators (two states with some of the highest uninsured rates for kids) just decided last week to keep moving forward. This week it seems their Republican colleagues in Congress are poised to take a vote that would pull the rug out from underneath their efforts to help uninsured kids in their states.