10-4-17 5:16 PM EDT | Email Article
By Michelle Hackman 

WASHINGTON -- As Congress struggles to reauthorize the broadly popular Children's Health Insurance Program, states are increasingly concerned lawmakers won't act quickly enough to help them avoid budget shortfalls and possibly a shutdown of some state programs by year's end.

House and Senate committees both approved packages Wednesday to renew spending on CHIP, days after Congress allowed the funding to expire over the weekend. CHIP, which serves nearly nine million low-income children whose parents make too much to qualify for Medicaid, cost the federal government $16 billion in 2016.

Republicans in the House, however, attached several measures that would cut into the Affordable Care Act, and people familiar with the talks said that could complicate negotiations and delay a final deal. The sticking points, including a proposed cut to an ACA public health fund, are contentious enough that aides say they could take months to resolve.

State officials are caught in the middle. A Kaiser Family Foundation survey of state CHIP directors found that 10 states anticipate exhausting their existing federal funding by December.

Several states have drawn up contingency plans that involve capping enrollment and possibly taking steps to shut down their programs should funding not come through in time.

Last week, Utah became the first state to request federal permission to wind down its program if Congress doesn't renew funding by the end of the year. Utah's program serves 19,000 children, and the state is also home to Senate Finance Committee Chairman Orrin Hatch (R., Utah.) who oversees CHIP in Congress and is an influential supporter of the program.

"We have heard that Congress is interested in providing funding for the program and we hope they follow through," said Nate Checketts, Utah's Medicaid director who oversees the CHIP program. "But we've heard that comment all year, and no action has been taken."

That delay has stemmed partly from Congress' entanglement in various proposals to repeal the ACA, which consumed large chunks of the legislative calendar before ending in failure.

CHIP, created by Mr. Hatch and the late Sen. Edward Kennedy (D., Mass.), enjoys broad backing from Republicans and Democrats. In hearings on Wednesday to advance the legislation, lawmakers in both parties said they hoped a final bill would reach President Donald Trump's desk soon.

The Senate committee was set to approve the package on a voice vote, while the House panel split largely along partisan lines. The timing for moving forward is tricky, since the Senate is in recess next week and the House is out the following week.

At issue are several provisions proposed by House Republicans to help pay for the cost of funding CHIP.

Democrats are particularly opposed to a plan to cut $6.4 billion from the ACA's prevention and public health fund. The fund is aimed at helping states administer vaccines and other public health measures, though Republicans frequently deride it as a slush fund.

The House bill also would tighten a grace period for premium payments by people buying insurance on the ACA federal marketplace. Democrats say that could put coverage out of reach for some people who are struggling to make their payments.

"For the last two years, Congress has known about this deadline. Yet here we are," said Rep. Jan Schakowsky (D., Ill.), who said she opposes cutting into other coverage to pay for CHIP.

House Republicans say they support the program but that the funding must come from somewhere. "While some have called these offsets partisan, we call them reasonable," said House Energy and Commerce Chairman Greg Walden (R., Ore.), referring to cuts intended to offset spending on CHIP.

The bill's sponsors need Democratic votes in the Senate, because it generally takes 60 votes in that chamber to pass legislation and Republicans hold a 52-48 majority.

The Trump administration is signaling it may be willing to shore up some state CHIP programs, at least for now. The Department of Health and Human Services on Monday sent Minnesota $3.6 million to help keep that state's CHIP program open through the end of October, a state official said.

An HHS spokesman said the federal government wouldn't be able to meet every state's projected shortfall because it is drawing from a limited pool of unused CHIP funds from recent years.

In Alabama, the state's CHIP director, Cathy Caldwell, said that if Congress doesn't act by early November, her state would be forced to begin changing eligibility requirements and removing some children from the rolls. Her program, which serves 83,000 children, would need to shut down entirely by February or March, she said.

"It is stressful that it hasn't happened yet, but we're trying to remain optimistic," Ms. Caldwell said.

--Kristina Peterson contributed to this article.

Write to Michelle Hackman at Michelle.Hackman@wsj.com


(END) Dow Jones Newswires

October 04, 2017 17:16 ET (21:16 GMT)

Copyright (c) 2017 Dow Jones & Company, Inc.
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