January 2, 2018

Trump signs law to fund CHIP through March—but will it be enough?

Daily Briefing

    Congress on Dec. 21 passed a short-term spending bill that funds the federal government through Jan. 19, 2018, and includes stop-gap funding for some health care programs.

    The House voted 231-188 to approve the bill, and the Senate voted 66-32 to approve the measure. President Trump signed the bill into law on Dec. 22.

    Bill details

    The bill includes $2.85 billion in funding for CHIP, which will be allocated for the first two quarters of fiscal year (FY) 2018, which began on Oct. 1, 2017, and will run through March 31, 2018. The bill also gives CMS extra flexibility to redistribute funding from states with an excess of funding to address any shortfalls states might face for CHIP.

    The bill also allocates for the first two quarters of FY 2018:

    • $550 million in funding for community health centers;
    • $65 million to the National Health Service Corps;
    • $37.5 million for the Special Diabetes Program for Type 1 Diabetes; and
    • $15 million to the Teaching Health Center Graduate Medical Education Program.

    The bill also provides $37.5 million for the Special Diabetes Program for Indians in the second quarter of FY 2018.

    In addition, the bill includes $2.1 billion in mandatory funding for the Veterans Choice Program.

    The short-term spending bill also includes offsets for the funds, including redirecting $750 million from the Affordable Care Act's Prevention and Public Health fund for other programs.

    Experts, stakeholders say short-term CHIP funding is inadequate

    Experts and stakeholders have said the short-term CHIP funding might not last states through March.

    Tricia Brooks, a senior fellow at Georgetown University's Center for Children and Families, said, "It is our understanding that the intent is to get states through at least February, but we have not arrived at a final conclusion about its adequacy." She added, "At this point, the trust states have in Congress' promise to get CHIP done has eroded. ... So it is unclear whether yet another short-term fix will be enough to convince states to delay any actions."

    Bruce Lesley of the advocacy group First Focus said the CHIP funding provided in the bill is not enough to keep states' CHIP programs funded through March. "The essence we're hearing from the states is that this helps a few states with a short-term patch, but for others it does nothing," he said.

    American Academy of Family Physicians President Michael Munger said, "A 3-month extension of CHIP gives families … only [a] brief reprieve from health insecurity." Munger continued, "Long-term funding is an absolute necessity, and it's incumbent on Congress to return to the work of passing funding legislation that ensures stability to CHIP and the children and expectant mothers who depend on it."

    Senate Finance Committee Orrin Hatch (R-Utah) said lawmakers "share a commitment to extend full funding for CHIP as soon as possible." He added, "In our view, a long-term, five-year extension of [CHIP] is essential to providing certainty for families and states. While the proposed short-term patch offers some funding relief, it falls short of providing families and states the certainty they need" (Frieden, MedPage Today, 12/21; Heavey/Lambert, Reuters, 12/22; AHA News, 12/22; Rovner, Kaiser Health News, 12/22; Luthi, Modern Healthcare, 12/21; Roubein/Sullivan, The Hill, 12/22).

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