Lately, there has been a lot of confusion surrounding the Children’s Health Insurance Program (CHIP), which provides low-cost health insurance to roughly 9 million children and hundreds of thousands of pregnant women who don’t qualify for Medicaid, but are still in need of assistance. In the past 20 years, CHIP has helped lower children’s uninsurance rates nationally from 14% to less than 4.5%. Unfortunately in September, due to the melee surrounding the attempt to repeal the Affordable Care Act, Congress missed a vital deadline: a reauthorization of the federal CHIP budget that would have extended its funding (as has been the case 3 times since 1997) to carry into 2018 and beyond.
This does not spell instantaneous disaster for CHIP, and for many states there is no reason to panic yet. Despite the failure of Congress to reauthorize federal funding for CHIP on September 30, millions of children did not wake up on October 1, 2017 without health insurance. Because CHIP is a partnership between the federal government and the states, only federal funding was discontinued on September 30, not state funding. The majority of states had budgeted money from the last reauthorization so that they had enough money to fund the program through the end of 2017 (though a few states, such as Minnesota and Utah, needed emergency funding to keep their CHIP programs running). However, states do largely rely on federal funding to help keep CHIP running, so CHIP programs within states cannot continue indefinitely without the reauthorization of federal funding for CHIP.
While Texas has not officially reported to the federal government when it will run out of funding for CHIP, Hurricane Harvey recovery efforts have complicated budgetary matters within the state. At this point, it is projected that Texas will run out of CHIP funds “as early as January ,” according to Texas Health and Human Services Commission (HHSC) spokesperson Carrie Williams. However, she did say that HHSC is “hopeful money will come down [from Congress] before the state runs out.” If this doesn’t happen, Texas will begin notifying families 30 days before it begins rolling back CHIP. So if CHIP funding is projected to run out on February 1, 2018, HHSC will be required to notify families covered by CHIP no later than January 1, 2018.
At this point, CHIP covers nearly 400,000 children in Texas, in addition to hundreds of thousands of pregnant women – bringing the total number of those covered under CHIP in Texas to nearly 1 million. Some states have provisions that would shift children covered under CHIP to be covered under Medicaid in the event that CHIP ceases to exist – at this point Texas is not one of those states. For Texas, the only solution to keeping these nearly 1 million children and pregnant women insured in 2018 and beyond is a reauthorization of federal CHIP funding.
Texans do not need to panic for now, but many are asking, “what is the future of CHIP?” That is largely unclear at this point. On November 3 the House of Representatives passed a bill that would renew CHIP for 5 years, but due to other provisions included in the bill (unrelated to CHIP funding), it is highly unlikely to pass in the Senate. A complete and final reauthorization of CHIP will require passage of a bill by both the House and Senate, followed by a presidential signature. Should the president veto the bill, it would go back to Congress for a veto override. So far, none of that has happened. At this point, it’s being predicted that CHIP reauthorization will be tied up in December budget negotiations, which will cover a whole array of budgetary issues, not just healthcare. For now, we will do our best to keep y’all updated on CHIP reauthorization, and how it will affect Texans.