House extends children’s health coverage, but Senate outlook unclear

The Children’s Health Insurance Program expired on Sept. 30, but states have used funding reserves to continue offering the program for low-income families. But that funding could run out if Congress does come up with a replacement soon. (Photo by Alex Proimos/Creative Commons)

Arizona’s CHIP program, known as KidsCare, was dropped by the state in 2011, but revived last year. The program has steadily grown since then, and it covered close to 24,000 Arizonans as of this monght, according to the latest state figures. (Photo by Britney Walker/Creative Commons)

WASHINGTON – The House Friday passed a GOP bill to extend the Children’s Health Insurance Program for five years by pulling funds from other programs under Obamacare, angering Democrats who called the cuts unnecessary.

It’s unclear how far the bill will go in the Senate, which is working on its own proposals, but if action is not taken soon states will start running out of money for the popular kids’ health care plan.

That is particularly true in Arizona, where state officials said they could run out of money by mid-December for the KidsCare program that serves just under 24,000 low-income kids. Gov. Doug Ducey said this week that he might use some of the state’s “rainy day” fund to keep the program afloat if Congress does not act soon.

The CHIP program expired Sept. 30 and states have been running on reserves since then, while Congress wrangles over a replacement.

The bill passed by the House Friday would extend the CHIP program for five years and keep funding for two years for certain community health centers and programs like the National Health Service Corps, according to a GOP-prepared summary. It would also add $1 billion in Medicaid funding for hurricane-battered Puerto Rico and the U.S. Virgin Islands.

But Democrats were quick to point out that the island funding was less than half of what officials there requested and would have to be matched by local dollars. The bill strips $6.35 billion from the Prevention and Public Health Fund, an Obamacare program that Democrats were particularly upset to see cut.

The bill also included a last-minute amendment for “means testing” of Medicare benefits, which would mean that senior citizens with incomes above $500,000 would have to bear the full cost of their Medicare coverage.

“I reject the notion we have to rob Peter to pay Paul,” Rep. Debbie Dingell, D-Michigan, said during floor debate Friday. “Or in this instance, jeopardize the future of Medicare and steal $6 billion from critical prevention programs to pay for children’s health care.”

The final 242-174 vote split largely along party lines, with all but three Republicans who voted Friday voting in favor of the bill and just 15 Democrats crossed the aisle to vote for it.

Three Arizona members were among those who bucked their parties, with Rep. Andy Biggs, R-Gilbert, voting no and Democratic Reps. Kyrsten Sinema of Phoenix and Tom O’Halleran of Sedona voting in favor.

Biggs did not respond to requests for comment, but Sinema said in a statement from her office that it was important to protect the thousands of Arizonans who could lose KidsCare coverage.

O’Halleran conceded there are problems with the bill, but said he voted for it to “send a clear message” that coverage for “vulnerable adults and children” is on the line.

“To keep negotiation running, I was willing to vote for this,” O’Halleran said. “Since we can’t have discussion on it in committees as it appears.”

Arizona had dropped its KidsCare program in 2011, but revived it last August. It has been growing steadily since, with more than 1,400 new clients added just the last two months, according to the most recent figures from the Arizona Health Care Cost Containment System.

KidsCare covers children whose families earn up to twice the federal poverty level, and was covering 23,849 Arizonans as of this month.

AHCCCS spokeswoman Heidi Capriotti said Arizona received enough funding from the Centers for Medicare and Medicaid Services to continue coverage “at least through November” and the state is looking to the federal government to find a solution before then.

“We fully expect that Congress will pass legislation and fund this program,” Capriotti said. Until then, CHIP enrollment will continue, she said.

But if Congress does not act, Ducey said he may use money from the state’s “rainy day fund” to keep it going until a more permanent solution can be found.

“Over 23,000 Arizona kids depend on this program for a wide variety of medical treatments, from setting a broken arm to cancer treatment,” he said in a letter to Congress this week that urged quick action. The letter pleaded with congressional lawmakers to “not pull the rug out from under thousands of Arizona’s kids.”

“There are a lot of things that divide us, but taking care of these kids is something that should unite us,” his letter said.

Despite the partisan sparring over the House bill, Molly Reynolds, a fellow in governance studies for the Brookings Institution said that, “Most people expect Congress will find a way to do this.”

“The question is how?” she said. “Do states try to put up the money themselves? Do they decide to wind down the program? One of the biggest challenges for states has been the uncertainty.”

Reynolds said Republicans’ unsuccessful efforts to repeal the Affordable Care Act, or Obamacare, this summer “interfered” with efforts to reauthorize CHIP before its Sept. 30 expiration. Renewal efforts were not helped by the Republicans’ funding cuts – or offsets to pay for CHIP – that made the bill “unpopular with Democrats,” she said.

But O’Halleran holds out hope that a solution can still be found with the Senate.

“This is the beginning of a process,” he said. “I’m hoping this comes back as a clean bill.”