CHIP funding set to expire without Congressional action

LAS VEGAS — Although the Children’s Health Insurance Program is authorized through 2019, federal funding for the program is set to expire in September 2015.

This could put access to medically comprehensive and developmentally appropriate health care for the 10 to 12 million low-income children who depend on the program at risk, according to a speaker at the National Association of Pediatric Nurse Practitioners (NAPNAP) 2015 meeting.

“Until children’s coverage available in health insurance marketplaces is improved and demonstrated to offer more comprehensive services from a full range of pediatric providers at an affordable cost, CHIP must be continued to ensure that our children have the coverage they need, when they need it,” said Laura Searcy, APRN, PCPNP-BC, chair of the NAPNAP health policy committee.

Since it’s inception, CHIP has reduced the number of uninsured children in the United States by half, from 25% to 13% between 1997 and 2012.

The Affordable Care Act (ACA) has extended the benefits of insurance coverage, but several issues remain. Private insurance plans and benchmark plans for state insurance marketplaces established under the ACA are based on adult formulated insurance plans and are not pediatric specific, according to Searcy.

“They don’t always include all of the things children need, the cost is usually much higher, and the coverage is inferior,” she explained.

Additionally, a loophole in the ACA, called the “family glitch” also limits the types of health insurance for which many children are eligible.

Under the ACA, the Internal Revenue Services ruled that individuals are eligible for subsidized health insurance through state marketplaces if employer-sponsored coverage exceeds 9.5% of their individual income. However, the cap on insurance costs only applies to single employee health insurance premiums and does not extend to families and dependents.

“Many families can’t afford family premiums, but aren’t eligible for insurance subsidies,” Searcy said. “The ‘family glitch’ currently prevents about 500,000 children from access to insurance coverage, and if CHIP funding is not reauthorized, this number could increase to 2 million.”

Congress must act this year to give states sufficient time to plan their budgets without cutting existing resources to children’s health programs.

Nurse practitioners should contact their local members of Congress to lobby for CHIP funding and explain the importance of the program, Searcy urged.

“CHIP has a long history of strong bipartisan support, but there are a lot of new members of Congress who may not be familiar with its history,” she said. “Unless Congress acts now, the funding stream for CHIP goes away.”