By Jocelyn Guyer
In an effort to circumvent the bipartisan debt ceiling agreement reached last year, the House Budget Committee passed a measure Monday that, if enacted, would undermine the success our nation has achieved in driving the uninsured rate for children down to a record low. (It has numerous other issues as well, and for a thorough review, we encourage you to see the Center on Budget and Policy Priorities latest paper on the topic.)
The legislation approved by the committee would eliminate automatic spending cuts (i.e., the “sequestration”) to discretionary programs slated to go into effect in 2013 under the bipartisan debt ceiling agreement reached last summer. As Say Ahhh readers know, the debt ceiling agreement called for the sequestration to occur if a “super committee” failed to develop an alternative way to address the budget deficit. And, fail it did.
The House is expected to pass the measure on Thursday, but the Senate has indicated that it is not interested in taking it up. Without action by Congress, the automatic cuts take effect in January 2013, as planned.
House Budget Chairman Paul Ryan has made an all-out effort to frame his package as cracking down on fraud, abuse and wasteful spending. But, those claims have been refuted and the proposal is being widely viewed as an effort to shield the Defense Department from cuts by extracting even more money out of programs that are important to low and moderate-income families. We would like to highlight two of the cuts that would turn the clock back on the success the U.S. has made in reducing the uninsured rate for children.
The plan would repeal the Medicaid and CHIP stability protection (aka maintenance of effort) provisions that have helped so many children maintain health care coverage during these tough economic times. As my colleague Martha Heberlein blogged about last week, If these protections were rescinded, coverage for more than a third of Medicaid and CHIP beneficiaries would be placed at risk. Without the stability protections, states could reduce coverage to mandatory federal minimum levels in Medicaid and scale back or even entirely eliminate their CHIP programs. (The last time this ugly provision reared its head, CBO estimated that over half of states would take this route.)
The measure would also eliminate a performance-based incentive plan that rewards states for doing an exemplary job of connecting uninsured kids to coverage. The incentive plan is one of several successful strategies that have helped to connect the lowest income uninsured children to coverage. Data on the bonuses show that in the 23 states that received bonuses in FY 2011, an additional 1.1 million kids were enrolled above expected level.
Medicaid and CHIP are cost effective programs that have helped meet a critical need for children and families across the country. It is troubling that there are attempts to cloak these cuts under the oft-repeated waste, fraud and abuse mantra. Research has shown that the likelihood of fraud and abuse on the part of Medicaid beneficiaries is extremely low and the experience of at least one state that has streamlined enrollment practices is that doing so actually helped it to reach a remarkably low error rate.
At CCF, we have found that streamlining enrollment does not translate to fraud and abuse. To the contrary, it takes a complex and confusing enrollment process, adds the latest technology to minimize duplication of effort, and creates a path to coverage that is both accurate and efficient at connecting children to coverage they are eligible to receive. In other words, it improves government efficiency, something that all policymakers should be able to support.
