CHIP future uncertain in healthcare reform

The Children's Dental Health Project (CDHP), along with other children's health advocacy groups, is lobbying to keep the Children's Health Insurance Program (CHIP) alive, at least for a few years, regardless of what new healthcare reform legislation comes out of the U.S. Congress this year.

CHIP provides health insurance to children between 100% and 200% of the federal poverty line, picking up where Medicaid leaves off. It includes dental benefits even for children who have other types of health insurance. The law authorizing the program expires Sept. 30, 2013.

In drafting bills to overhaul the U.S. healthcare system, various committees of Congress have dealt differently with CHIP. A joint bill by three committees of the House of Representatives would allow CHIP to expire in 2013, moving these children into insurance policies offered through a public exchange. The federal government would subsidize these policies on a sliding scale for families below 400% of the federal poverty level.

The Senate Health Education Labor and Pensions (HELP) Committee bill barely deals with CHIP, which is considered outside its jurisdiction. The Senate Finance Committee bill keeps CHIP alive until 2019, before moving beneficiaries to its version of the public exchange (which it refers to as a gateway), where their insurance coverage would also be subsidized depending on needs.

Both the House and Senate Finance bills include provisions, introduced as amendments to their original versions, that would ensure no one is moved into the exchange until it can provide coverage and cost-sharing at least comparable to CHIP.

On October 23, CDHP signed onto a letter asking Senate leaders to retain these provisions in the final version of its legislation. The letter also asks the Senate to provide funding for CHIP through 2019, which they say is not ensured in the language of the bill as it stands.

Other signatories are American Academy of Child and Adolescent Psychiatry, American Academy of Pediatrics, Children’s Defense Fund, Children’s Health Fund, Family Voices, First Focus, March of Dimes, National Assembly on School-Based Health Care, National Association of Children’s Hospitals, and Voices for America’s Children.