Obamacare’s Next Battleground: Children’s Health Insurance

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By Alex Ruoff

Senate Republicans want to include portions of their Obamacare repeal bill in legislation to reauthorize the Children’s Health Insurance Program, lawmakers told Bloomberg BNA.

If Republicans can’t pass a major overhaul of the Affordable Care Act in the weeks after they return from the August recess, they’ll look to the CHIP funding bill as a possible vehicle for it, Sen. John Cornyn (R-Texas), the majority whip, told Bloomberg BNA Aug. 3.

“At some point we have to break the stalemate because obviously we’re stuck, and I’m for us getting unstuck,” Cornyn, a member of the Senate Finance Committee, which is charged with reauthorizing CHIP, said. “I think that presents an opportunity, the next best opportunity.”

Senate Republicans fell one vote short of passing an ACA repeal bill in July, and many are hoping a new plan, created by Sens. Bill Cassidy (R-La.) and Lindsey Graham (R-S.C.), can unite them in September, when they return from their August recess.

However, it’s unclear how much support there is for their repeal plan, which would convert the ACA’s insurance subsidies and Medicaid into block grants largely controlled by individual states, and whether it can be passed via the filibuster-proof reconciliation process Republicans need to pass legislation without Democrats’ support.

Those eager to pass at least some elements of an ACA repeal bill, such as rolling back or ending the requirements that all Americans have health insurance and most employers extend insurance to their employees, are likely to try to attach them to legislation considered must-pass.

Congress will return to face several pressing issues in September: They must pass legislation funding the government and increasing the country’s debt ceiling. Some Republicans, including the head of the Senate Finance Committee, have said their main concern after recess will be tax reform, which could put Obamacare repeal on the back burner for the immediate future.

A Pressing Matter

The Senate Finance Committee will hold a hearing on CHIP in early September. Lawmakers hope to produce a funding bill before the end of that month, according to lawmakers and a health lobbyist.

The 20-year-old public insurance program extends coverage for kids whose families fall in the gap between meeting eligibility for Medicaid and being able to afford other types of private insurance, with 46 states and the District of Columbia insuring children up to or above 200 percent of the federal poverty level. Over the years the program has expanded to cover pregnant women and roll out childhood obesity programs.

Funding for CHIP is set to run out Sept. 30. Several states will exhaust their CHIP funds by December and nearly all states will exhaust their CHIP funds by March 2018, according to congressional advisers.

Democrats and Republican committee leaders are pushing for a relatively clean CHIP bill, Sen. Ron Wyden (D-Ore.) told Bloomberg BNA. Adding ACA elements to the legislation might delay its passage, putting added pressure on states to keep the programs afloat as they wait for federal funds to be approved.

Only the House has held a hearing on CHIP this year, and crucial details remain unresolved, such as how long funding should be extended for the program and whether any changes need to be made to it.

Rep. Greg Walden (R-Ore.), chairman of the House Energy and Commerce Committee, told Bloomberg BNA in July that Congress is considering either extending CHIP two years or seeking a longer-term approval.

Lawmakers are in discussions over which should happen and when the call should be made. Further, congressional Republicans are asking Democrats what they’re looking for in reauthorization.

Repeal Push

The leaders of the Senate Finance Committee purposefully scheduled hearings on both CHIP funding and on the Affordable Care Act in September in hope of separating the two issues, Wyden said. A clean CHIP bill, one with reforms supported by both Democrats and Republicans, could pass the Senate in a few weeks, he said.

“You can’t control a member from trying to offer something, but we both feel it’s urgent business to pass CHIP,” Wyden said, referring to himself and Finance Committee Chairman Sen. Orrin Hatch (R-Utah).

CHIP funding bills are often vehicles for legislation that might not otherwise pass, Hatch, who helped created the CHIP program as a senator 20 years ago, told reporters. Both parties generally agree the program should continue, so the legislation is considered a must-pass.

“CHIP is always being used by both sides,” he said. “It’s a shame because it’s the one bill that does bring us all together.”

To contact the reporter on this story: Alex Ruoff in Washington at aruoff@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

Copyright © 2017 The Bureau of National Affairs, Inc. All Rights Reserved.

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