Another 'cliff' for Congress, Minnesota: The Children's Health Insurance Program

Anticipation of congressional cliffhangers has been running high this month as talk of a government shutdown and another attempt to repeal the Affordable Care Act appeared steadily in the news. Many of the changes being considered by Congress, particularly the Graham-Cassidy ACA repeal bill, would have disastrous effects for the 1 million families served each month by Minnesota's Department of Human Services. Amid this backdrop, our state also faces yet another major but lesser-known congressional "cliff": the expiration of the federal Children's Health Insurance Program (CHIP).

CHIP helps pay for needed doctor visits and vaccinations for more than 125,000 children in Minnesota. It provides families the security that comes from knowing they can access health care for their children. The program's funding also pays for prenatal and postpartum care for roughly 1,700 low-income pregnant women in our state who are not eligible for health care coverage through Medicaid.

Federal funding for CHIP expires on Sept. 30, 2017, and Minnesota is scheduled to exhaust its 2017 CHIP funds of $115 million by the end of the month. Should Congress not act in time to fund CHIP, our department will have to take extraordinary measures and face significant costs to continue coverage for children and pregnant women. If Sept. 30 approaches and Congress has not acted, our state's reimbursement from the federal government for children's CHIP coverage would decrease abruptly and pregnant women covered by the program would be cut off altogether, losing coverage for prenatal and postpartum care.

As a stopgap measure to continue coverage for pregnant women should Congress not act in time, our department would have to carry over funds from our existing 2017 CHIP allotment. Doing so, however, comes with a $10 million penalty from the federal government, an expensive result of congressional inaction but better than terminating coverage altogether.

The Senate announced a bipartisan agreement last week to reauthorize CHIP for five years. It is promising that senators are working on a bipartisan basis to prioritize this program. While the details of the agreement have not yet been released, it appears that a temporary boost in CHIP federal funding that was part of the ACA is eliminated by 2021. The amount that Minnesota received from that boost in funding is roughly $60 million per year, funds that help support health care coverage for Minnesota children.

I have written to Minnesota's congressional delegation on this matter (to read the letter, see: http://bit.ly/2eYgvdZ) and asked that members of Congress come together, once again, to fully fund CHIP. Having been created by Democratic Sen. Ted Kennedy and Republican Sen. Orrin Hatch in 1997, the program's long bipartisan history offers a strong road map to get there. It is my hope, for health care in Minnesota, that the Graham-Cassidy bill does not have the votes it needs to pass and that Congress can instead focus on reauthorizing CHIP for five years before Sept. 30.

Emily Piper is commissioner of the Minnesota Department of Human Services.