Congress needs to reauthorize funding for the Child Health Insurance Program (CHIP) now. If Congress fails to act before the end of December, many states, including ours, will most likely freeze CHIP enrollment since the states will run out of money to operate CHIP in early 2018.
Congress created CHIP in 1997 as a block grant to assist the states in making sure that children born into Medicaid could remain in Medicaid or CHIP until they reached the age of 19 years. Before CHIP, if a baby was born into Medicaid because the family income was at or below 185 percent of Federal Poverty Guidelines (FPG) ($45, 000 for a family of four), that baby could lose Medicaid coverage at age 1 if the family income had not dropped to 133 percent or less of FPG ($39,000 for a family of four). If the child’s family income did not drop to 100 percent or less of FPG ($28,000 for a family of four) by age 6, the child’s Medicaid coverage was terminated.
When North Carolina was given the opportunity to develop a CHIP program, I was leading legislative efforts for the N.C. Pediatric Society. Republicans controlled the House. Democrats controlled the Senate. We worked with the Republican leadership in the House to develop N.C. Health Choice as the CHIP program for North Carolina, and Blue Cross was chosen as the administrator of this unique program, which has served our low-income children and their families well for 20 years. Gov. Hunt and the Democrats supported our CHIP efforts, and the governor appointed me to chair the Commission on Children with Special Needs for CHIP from 1998 until 2002; this commission made sure that children covered by CHIP had access to the same benefits available through Medicaid. N.C. Health Choice is a model that other states can emulate. Government leaders should not terminate this program.
During the last 10 years, the legislature moved the administration of the program from Blue Cross to the N.C. Department of Health and Human Services to reduce administrative costs. We currently have a seamless system of care for low-income children who qualify for Medicaid or CHIP. Parents, children and providers are happy with the way our system works to improve access and quality.
Goldsboro Pediatrics provides a medical home for more than 20,000 children who are eligible for Medicaid or CHIP. Approximately 250,000 children in North Carolina depend upon CHIP funding for essential health services. If Congress does not reauthorize CHIP funding and our state cannot find the money to continue CHIP, then providers will be in the uncomfortable predicament of terminating children born into Medicaid whose family incomes do not drop by the time they reach one year and six years of age, according to federal guidelines. If these CHIP children do not have health insurance, it is unlikely their families can afford to pay out-of-pocket for necessary health services.
Please let your members of Congress know that they should reauthorize funding of CHIP. We should be investing in our low-income children, not making it more difficult for them to succeed in life.
David T. Tayloe Jr., MD, is a pediatrician at Goldsboro Pediatrics in Goldsboro.