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Get ready for the next big health care fight. This one’s all about kids

WASHINGTON — Senate Republicans say it’s time to “move on” after the sudden defeat of their efforts to dismantle Obamacare. But the health policy break won’t last long: A key program providing health insurance for millions of kids will run out of federal funding in a matter of weeks, unless Congress acts.

The Children’s Health Insurance Program, or CHIP, has long had strong bipartisan support; it provides health insurance for children in families with modest incomes that might be too high to qualify for Medicaid. Its authorization expires at the end of September, and at least five states will exhaust their leftover funds by the end of this year.

With that deadline looming, lawmakers and lobbyists are already eyeing a CHIP reauthorization bill as a potential vehicle for other priorities. Republicans could try to add language to repeal elements of Obamacare. Democrats might try to boost funding to stabilize the insurance markets.

At best, that means complicated and partisan negotiations — and lawmakers don’t have time to spare.

“It makes it a harder vote. Anytime you look at moving anything [after] you have a major piece of legislation that hasn’t moved, it becomes a negotiating tool — rightly or wrongly, it does. At this point, that does make it more difficult,” Rep. Mark Meadows, (R-N.C.), told STAT on Friday.

“I think we get there, just because of the importance of the program, [but] it may be an opportunity to look at other aspects to attach to it,” Meadows said.

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Meadows, who chairs the ultra-conservative House Freedom Caucus, has been at the center of the party’s negotiations to repeal and replace the Affordable Care Act. He said Friday he isn’t willing to give up that fight yet — whether that means writing a brand new bill or trying to add elements of repeal and replace to CHIP if Democrats push for their own policy changes.

Meanwhile, Rep. Greg Walden (R-Oregon) is signaling that the GOP may not feel pressure to advance the legislation rapidly, despite the deadline.

“While it needs to be reauthorized by September, virtually every state has funds — most of which don’t begin to run out at the earliest in October, some then in December, and many next year,” said Walden, who chairs the Energy and Commerce Committee. “We’ve got a little window here, but we intend to meet our deadlines.”

Asked whether his committee was working on a bill or what the next steps might include, Walden said only that those questions are “undetermined.”

A spokeswoman for Sen. Finance Committee Orrin Hatch of Utah, who would work on the companion effort in the Senate, did not comment. But his ranking member Sen. Ron Wyden of Oregon said via a spokesman that he is “eager” to work on a bipartisan package “so kids and their families are no longer left wondering if they will have health care at the end of September.”

Democratic leaders in both the House and Senate made little mention of CHIP in press conferences Friday.

Instead, their focus is securing funding for the cost sharing subsidies that help low-income Americans on Obamacare afford their deductibles and co-pays. Thanks to a court case brought by Republicans in Congress, President Trump and his administration have wide latitude to end the subsidies whenever they like, which could upend some insurance markets.

Securing that funding has been a major priority for insurance companies who participate in the law. But Sen. Majority Leader Mitch McConnell suggested late Thursday, after the collapse of his repeal bill, that he had little interest in passing them.

Several lobbyists suggested that it was far too soon for clear signals about the path forward, but said they expected CHIP would be the first opportunity to reignite discussion on broader health care reform.

Even if CHIP isn’t bogged down in the repeal and replace fight, lawmakers will still have to work out several major decisions about the program itself. Republicans have pushed in recent years to scale back the increased funding for CHIP included in the Affordable Care Act. Democrats have defended the higher federal spending.

To date, lawmakers and their staff have done little to prepare for the CHIP debate. There has only been one congressional hearing on the issue this year, and no public legislation yet exists. Advocates and staffers said that’s because both parties have been so focused on repeal.

“A lot of staff has been thinking about it, a lot of members and groups have been thinking about it, but the focus has been on the bigger Medicaid effort… You’re going to see a lot of folks shift now and say, ‘OK, let’s get CHIP done,’ ” said Jim Kaufman, vice president of Public Policy for the Children’s Hospital Association. “There’s been a lot of talk of bipartisanship, especially in the last week, and CHIP is the poster child for bipartisanship.”

This article is reproduced with permission from STAT. It was first published on July 28, 2017. Find the original story here.

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