Congressional authorization of Federal funds for CHIP expired on September 30, 2017. Nine million children depend on this program. States are now operating CHIP on carryover and redistribution payments from prior years. CMS estimates that at least one state will exhaust such funding in this month. Most states could exhaust such funding by March 2018.
On November 3, 2017, the U.S. House of Representatives passed H.R. 3922, the Championing Healthy Kids Act, which includes a five-year extension of CHIP through Federal fiscal year 2022. Federal funding for CHIP in FFY 2018 would be $21.5 billion under that bill. Such funding would reach $25.9 billion in FFY 2022. H.R. 3922 also includes continued funding for the National Health Service Corps, the Teaching Health Center Graduate Medical Education program, and other important Federal health care grant programs.
The U.S. Senate has not yet passed legislation to reauthorize CHIP. The Senate Finance Committee favorably reported out a bill on October 4, 2017 that would reauthorize Federal funding for CHIP for FFY 2018-2022. The committee’s bill would extend through FFY 2019 a 23 percentage point increase in the CHIP federal matching rate that was enacted as part of the Affordable Care Act (ACA), cut that increase in half in FFY 2020, and eliminate that increase in FFY 2021. It would also extend through FFY 2022 the child enrollment contingency fund and the Express Lane eligibility option, through which states can use income data from other programs to determine CHIP eligibility. The full Senate has not yet voted on it. If different packages pass the House and Senate, those differences will need to be addressed before the bill can head to the President.
CMS issued a bulletin on November 9, 2017 on major issues and steps that states must now consider in the absence of CHIP reauthorization. Those include notifications to CHIP families and stakeholders, eligibility and enrollment systems changes, eligibility redeterminations, contract revisions, and state plan amendments. The CMS bulletin is available here: https://www.medicaid.gov/federal-policy-guidance/downloads/cib110917.pdf
The CHIP funding crisis has major, immediate implications for State Medicaid/CHIP budgets and program operations. States considering next steps in light of the uncertainty of reauthorization may want to explore these resources.
- October 4, 2017 Kaiser report on the “Current Status of State Planning for the Future of CHIP”
- November 2017 National Academy of State Health Policy checklist “State Checklist for Shutting Down CHIP Programs”
- National Academy of State Health Policy article from this past summer “A Timeline of State Policy & Operational Considerations if Federal CHIP Funding Ends for States”
PCG will monitor on-going developments.