CHIP Temporarily Funded, PPHF Cuts Included in Short-Term Government Funding Measure Passed by Congress

Late this week, Congress passed another short-term government funding measure, once again narrowly avoiding a government shutdown. Recall, Congress passed a two-week funding measure on December 7 that extended current federal government funding levels through today, December 22. Congressional Republicans were left scrambling to piece together a funding measure earlier this week after placing much of their focus on the tax reform measure that was passed on Wednesday.

The stopgap spending bill that was passed in the House and Senate on Thursday extends current federal funding through January 19, 2018. The measure provides temporary funding extensions for a handful of programs, including, most notably, the Children’s Health Insurance Program (CHIP) and community health centers.

CHIP will receive $2.85 billion and community health centers and related programs will receive $550 million. Funding for CHIP and community health centers previously expired on September 30, 2017, and will now expire on March 31, 2018.

The temporary funding authorizations for CHIP and community health centers will be offset by cutting $750 million from Prevention and Public Health Fund (PPHF) between FY 2019 and FY 2022. At this time it is unclear what impact the PPHF cuts will have on the U.S. Centers for Disease Control and Prevention (CDC). The PPHF provides approximately 12 percent of the CDC’s yearly budget.

Given the delay by Congress to reauthorize CHIP funding, states and families throughout the country have been increasingly worried about the fate of the program. Several states, including Colorado, Utah, Connecticut, Alabama, and Virginia, had previously sent out notifications to families indicating that their coverage may be terminated at the end of January without a Congressional reauthorization.

California previously indicated that its funding would have run out in early January or perhaps even sooner without federal reauthorization. No coverage-loss notifications were sent to enrollees, largely because nearly all California CHIP beneficiaries were rolled into Medi-Cal for administrative purposes as part of the Affordable Care Act (ACA) Medicaid Expansion in 2014. California agreed with the federal government to keep these children enrolled in Medi-Cal through September 2019. Though, there remain in upward of 32,000 California children not included in the Medi-Cal arrangement that could be impacted without a long-term Congressional reauthorization.

This week’s temporary CHIP funding authorization provides states reprieve for several months, but it is reported that that the funds will likely be depleted before the end of March. The Centers for Medicare and Medicaid Services (CMS) recently released guidance indicating states are spending CHIP funds faster than initially projected.

Since CHIP’s previous expiration at the end of September, states have relied on supplemental federal funds and other sparse reserves to maintain CHIP. Despite this week’s temporary funding, states are likely to still brace for CHIP shutdowns in the spring. States and families throughout the country continue to highlight the need for a long-term funding authorization by Congress.

The House and Senate have agreed, in principle, on a five year extension of the CHIP program. However, there appears to be no consensus on how to fund the program. Congressional Republicans have proposed funding CHIP by cutting and modifying other health-related programs, including Prevention and Public Health Fund (PPHF) and Medicare. Congressional Democrats are opposed to using funds from other health programs to fund CHIP.

On other health-related matters, it was previously expected that Senate Republicans would include provisions in this week’s continuing resolution to address Affordable Care Act (ACA) marketplace stability with a measure from Senators Lamar Alexander (R-Tennessee) and Patty Murray (D-Washington) to fund cost-sharing reduction (CSR) payments to health insurers. A separate measure from Senators Susan Collins (R-Maine) and Bill Nelson (D-Florida) to provide reinsurance funding to help health insurers cover high-risk enrollees has also been proposed.

However, with limited time remaining before a government shutdown and disinterest among other Congressional Republicans, neither the CSR measure nor the reinsurance funding measure was offered as part of this week’s continuing resolution. Senators Collins and Alexander indicated they would take up their respective legislation upon their return after the holidays.

Congress notably declined to address a host of other pressing issues in the continuing resolution before recessing late Thursday. Upon their return in January, Congress will need to nearly immediately begin work on a full-year funding measure that will likely include provisions for fixes to the Affordable Care Act (ACA), a long-term CHIP reauthorization, immigration, national security, and defense spending, among other items.