Pulse on Policy

Expiration of CHIP: Putting the Health Care of Millions of Children at Risk

On September 30, 2017, Children’s Health Insurance Program (CHIP) expired without reauthorization. Even though a bipartisan bill for extension of CHIP was introduced last month, it was never brought to a vote. If no action is taken, 8.9 million children in the United States will lose their health insurance coverage. In Missouri, about 87,790 children are in danger of losing their coverage. The uncertainty of the future of CHIP has caused confusion for families concerned about access to healthcare for their children.

In 1997, CHIP was enacted by Congress with strong bipartisan support in order to provide health insurance coverage for children who were neither eligible for Medicaid nor employer-based insurance. At the time of CHIP’s enactment, 23% of low-income children living at or below 200% of the Federal Poverty Level lacked insurance coverage. Since then, the percentage of uninsured children has fallen below 10%, both nationally and statewide, largely due to expansions in Medicaid and CHIP.

Now that CHIP has failed to be reauthorized, states may use federal funds that have rolled over from previous years. However, they will eventually experience a budget shortfall and CHIP may be terminated. The Medicaid and CHIP Payment and Access Commission (MACPAC) and The Kaiser Family Foundation report that at least 3 and up to 11 states will run out of the funding in December. Most states (48 of 50) are expecting CHIP to be reauthorized and no contingency plans to extend coverage have been developed. In Missouri, the funding is projected to be exhausted in March 2018.

In order to maintain hard-won gains in children’s health insurance coverage, Congress needs to reauthorize CHIP. Tim McBride, professor at the Brown School and director of the Center for Health Economics and Policy stated, “It should be obvious that this is a great investment in our future, because if medical problems can be avoided when children are young, they are much more likely to do better in school and be more productive members of society. Also, it would be penny-wise, pound-foolish not to deal with this problem now. Covering children is a lot cheaper than covering anyone else, and the costs of health care only increases when care is delayed.” McBride provides a deeper dive into the devastating impacts of CHIPS’ demise in this St. Louis Post-Dispatch article, released on November 8, 2017.

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