For 20 years, since two of the Senate’s unlikeliest best friends—Utah Republican Orrin Hatch and Massachusetts Democrat Ted Kennedy—sponsored the Children’s Health Insurance Program, it has thrived and grown and received routine reauthorization and funding.
Hugely successful and backed by both parties, it has helped to reduce the percentage of children without health insurance to an all-time low of just over 4 percent.
This year, for the first time in the popular program’s history, Congress did not act before a Sept. 30 deadline, creating hardships for states, and forcing some to warn they will stop taking new CHIP enrollees until they are assured of new funding.
It should have been a great relief when legislation to fund CHIP for five years passed the House resoundingly last week. It now awaits action in the Senate, where—incredibly—its future is in doubt.
How can that be? When you dig into the numbers, only 15 Democrats joined 227 Republicans in last Friday’s House vote. Only three Republicans voted against it. Democrats have been CHIP’s biggest boosters, so what’s the problem with the legislation from their perspective?
It’s the “pay-fors,” congressional jargon for where the money will come from to fund CHIP. The House has come up with several approaches that fall into the “rob Peter to pay Paul” category, taking from other popular health programs so that eliminating one debt creates another.
The most mean-spirited and petty of these approaches continues the GOP’s attack on Obamacare by shortening the grace period for paying premiums from the current 90 days to 30 days. The left-leaning Center on Budget and Policy Priorities estimates that up to nearly 700,000 people could lose their health care insurance under those stricter terms.
It’s the equivalent of “holding people’s care hostage,” says Sam Berger, senior policy adviser with the liberal Center for American Progress. “They’re putting children at risk to move forward in their efforts to sabotage the ACA.”
“It’s a horrible idea, incredibly mean-spirited,” says Matt Bennett with Third Way, a moderate Democratic group. “It shows you just how soulless the Republican Party has become. They could take almost any element of their tax cut to benefit the rich and pay for CHIP 40 times over. It’s not a terribly expensive program, and it benefits poor, sick children. What is wrong with these people?”
Tara Straw, a senior policy analyst at the Center on Budget and Policy Priorities (CBPP) said in a phone call with The Daily Beast that what’s really cynical about this is that all of the savings the Congressional Budget Office has found “come from people who would have caught up on their premium.” These are people who often have trouble paying their bills and meeting basic expenses, but they catch up within the 90-day window.
CHIP has been a model of bicameral, bipartisan accord, and Edwin Park, vice president of health policy at CBPP, says “there’s still optimism” that Sen. Hatch, who helped create CHIP and now chairs the Senate Finance Committee, will be able to work out a funding mechanism with ranking Democrat Ron Wyden that doesn’t raise partisan hackles, and it will all be wrapped up in a December mega-funding bill that will require 60 votes and therefore cannot be passed with Republicans alone.
The House bill calls for wealthier seniors to pay higher Medicare premiums, an area of great political sensitivity and an apparent violation of candidate Donald Trump’s pledge to leave Medicare alone. Democrats, who generally favor taxing the rich, say higher earners are already paying more, and maintain that the program’s strength is its universality, that it’s not a welfare program.
Either way, touching Medicare in any way is a high-risk undertaking for politicians. AARP, the powerful lobby for older Americans, opposes the increase in Medicare premiums.
Republican Greg Walden of Oregon, chief author and proponent of the bill, was quoted in The New York Times saying, “We are just asking the wealthiest seniors in America, those making $40,000 a month—not a year, a month—to pay about $135 a month more for their Medicare, so we can fund children’s health insurance for five years.”
Republicans also raid the Prevention and Public Health Fund that was created under Obamacare and that now provides almost a billion dollars annually to the Centers for Disease Control and Prevention for everything from disease outbreaks to prevention of bioterrorism. The money is a significant portion of the CDC’s budget.
Democrats oppose taking money from the Public Health Fund, which Walden called their opposition “ironic and cynical” since Democrats have dipped into the fund in the past when it suited their interests.
“It is a tragedy that this is not a bipartisan bill, as it always has been,” Walden said.
In addition to funding CHIP and the Community Health Centers that care for low-income children, the House bill sends an additional billion dollars in Medicaid funds to Puerto Rico. There’s a lot that both parties like in the bill, and it’s emblematic of the dysfunction in Congress that they haven’t yet found a funding formula that isn’t an extension of the grudge match over Obamacare.