Children's health insurance is politicized for the first time
In the 20 years since Republican Sen. Orrin Hatch and Democratic Sen. Edward Kennedy introduced the Children's Health Insurance Program, it's never been used by either party as leverage to further other political goals.
CHIP provides insurance for almost 9 million children and several hundred thousand pregnant women who aren't quite poor enough to qualify for Medicaid but still can't afford private insurance. That includes 700,000 recipients in New York State.
The lack of political horse-trading around CHIP for two decades represented a sort of pact, or social contract. It was as if politicians of all persuasions had agreed that health care for kids whose families could not otherwise afford it was an untouchable, unquestionable priority.
Funding for CHIP, which costs the federal government about $14 billion a year, ran out on Sept. 30, and Congress has refused to reauthorize it. The states, which administer CHIP, have mostly scraped together enough funding to keep their programs going, but that will soon cease to be true. In New York State, officials say funds could run out by March. In other states, like Connecticut, the well could run dry in just a few weeks.
The blame falls squarely on Republicans, whose House bill to fund CHIP for five more years included cuts to the Prevention and Public Health Fund, which helps fight the opioid epidemic. That bill also sought to raise money by shortening the grace period before people would be dropped from Affordable Care Act insurance plans for nonpayment, and it would have added a surtax on wealthy Medicare recipients. Democrats were unwilling to attach CHIP funding to those conditions, and they were right.
It's also worth noting that tobacco tax increases in 1997 and 2009 that raise $11 billion a year and took the per-pack levy from 24 cents to $1.01 are still being collected even as CHIP remains unfunded and were, when enacted, justified by politicians as direct funding for CHIP.
Republicans are approving a tax-code overhaul that's projected to add $1.5 trillion to the national debt over 10 years, with most of that money going to the very rich. The GOP is not demanding that the shortfall be paid for. But to Republicans, providing health care for kids simply demands that the nation cut addiction treatment.
The entire federal government is due to run out of funding, and it's going to take both Republican and Democratic votes to pass a spending authorization. Democrats must demand that the funding bill include a 5-year reauthorization of CHIP with no strings attached.
House Speaker Paul Ryan and other Republican leaders have made it clear they want to pay for their tax extravaganza by cutting Medicare, Medicaid and Social Security in the new year. In that context, the haggling over CHIP feels like a test case to see whether both Democratic and Republican politicians, as well as the public, will roll over for such attacks on crucial and previously untouchable programs.
The answer has to be no, and CHIP funding has to be the vehicle by which that answer is delivered.