What Is CHIP, And Why Does Its Lapsing Put So Many Kids At Risk?


Last night, Jimmy Kimmel got in front of America and put his weight behind what’s been a fight behind the scenes between politicians and health care advocates for more than two months. The Children’s Health Insurance Program, or CHIP, expired on September 30th, and if it’s not renewed quickly, nine million children might get booted off their insurance. So what is CHIP, and why can’t Congress continue to fund a seeming slam-dunk of a program?

  • CHIP was designed back in 1997 to fix a flaw in the health care system: After Clinton’s push to pass extensive health care reform failed in 1993, politicians decided that instead of a comprehensive bill, which was a rushed and politically fraught process even then, they’d assemble a new health care system piece by piece. CHIP was one of those pieces.
  • CHIP offers matching funds to states to insure at-risk kids: There was, at the time, a gap where families made enough money to be outside Medicare’s qualifications, but not enough money to pay for comprehensive medical care for their children. CHIP was designed to complement state-level programs to fill that gap; every state has a program that qualifies for CHIP.
  • CHIP, it must be said, isn’t perfect: There are still some fairly large gaps in the system that kids slip through, and expanding CHIP has been nearly impossible. George W. Bush vetoed two attempts to expand the program, and the best Obama could do with a Republican Congress was simply get it reauthorized. Still, it covers the health insurance of nearly nine million children, or rather, it did.
  • CHIP needs to be reauthorized by Congress every few years, and Congress blew past its September 30th deadline: CHIP is incredibly popular across the political spectrum; leaving aside that letting kids die is obviously a bad look, politically, it’s a relatively low budget program with widespread social benefit. But Congress was so busy trying to repeal the Affordable Care Act, which ultimately failed, there was no room in the schedule to reauthorize CHIP. Nor is it a Congressional priority at the moment, since they’re trying to ram through a tax bill before Christmas. If that weren’t enough, the funding for the entire federal government is at risk if the GOP doesn’t pass a funding package by December 22nd.
  • As a result, programs funded by CHIP are in peril: The state programs running on CHIP are acting as if they’re about to lose funding and are scrambling, where they can, to fill the gap or at least let families know. According to the Kaiser Family Foundation, 16 states will be out of CHIP funding by the end of January, and only 11 states have the money on the books to make it to April. Even those estimates may be optimistic.

Will Congress renew CHIP? Good question. Normally this would be a simple matter, but this degree of government dysfunction, and the GOP’s focus on its tax bill to the seeming exclusion of all else, complicates what should be a slam dunk. One thing, however, is certain: CHIP is fairly popular among voters, and the Kaiser Family Foundation has found that for the voters it spoke to, renewing it is a top priority, above even stabilizing premiums in ACA marketplaces and other hot-button health care issues. Voters were already watching the issue, and don’t be surprised if, as 2018 inches closer, Congress starts feeling the heat.