Congress Returns (copy) (copy) (copy)

An American flag flies over Capitol Hill in Washington. 

Susan Walsh, Associated Press

Here's news that would be unbelievable if it didn't involve Congress: As states like Oregon are running out of money to fund the Children's Health Insurance Program, Congress still has failed to renew the program.

The program, which likely is better known by its CHIP acronym, provides health benefits to almost 9 million children whose families earn too much to be eligible for Medicaid but cannot afford private insurance. It has enjoyed bipartisan support since it was enacted in 1997.

But funding for the program expired at the end of September. According to a recent story from the Reuters news agency, congressional Republicans tied CHIP renewal to other legislative battles, such as attempts to repeal the Affordable Care Act and the continuing effort to pass a tax-reform bill. 

Lawmakers had said they hoped to pass a five-year CHIP funding extension before they adjourned for the year. But congressional aides now say they might not get to it until early 2018.

In the meantime, states are beginning to run out of money to fund the program. Some states are sending notices to thousands of families that the 20-year-old program soon will need to shut down for lack of cash. In other states, families are being told to renew prescriptions as soon as possible and try to squeeze in doctor's appointments by the end of the year.

Oregon is among five states and the District of Columbia that likely will be among the first to run out of funding for CHIP. In Oregon, the program provides coverage for about 120,000 children and 1,700 pregnant women.

Gov. Kate Brown said last month that the state will pick up the tab for the program even if the federal money runs out. State officials believe that some 40,000 of the covered children will have to move to Medicaid, known here as the Oregon Health Plan. But the state would have to pay to keep coverage for the remaining 79,000 children. To her credit, Brown said she wanted to make that announcement as soon as possible to try to alleviate some measure of uncertainty for families covered by the program. 

Now, it's true that the financial risk to Oregon is relatively low. Observers expect that Congress eventually will pass an extension to the insurance program, and that federal payments when they resume will be made retroactive to Oct. 1. That means states like Oregon which have had to put in their own money to keep the program running would be made whole.

But there is some risk to Oregon: These same observers also thought that extending the program is such an obviously good thing that Congress would have taken care of it by now. Maybe, with the tax-cut bill expected to pass Congress this week, senators and representatives will be able to handle this nagging CHIP business before they blow out of town on their Christmas recess.

A couple of frustrating ironies stand out in all this: First, this insurance program is an excellent example of how a little bit of government money spent upfront saves considerably more money down the road. Before CHIP established a safety net for children and families, families without coverage sometimes would wait to get medical care for their children until symptoms became so serious that a trip to the emergency room was the only option. And those emergency room visits are the most expensive stop in the health care system. 

The second irony is particularly frustrating: Because Congress has been so focused on a tax bill that may offer some tax relief to the working poor of the United States (but more tax relief, naturally, to the wealthy and to corporations), it was unable to find the time to renew a program that offers concrete benefits to those same people. The worst part about this second irony is that it's not a surprise. (mm)


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