December 15, 2017

A big cost to NM if Congress doesn’t act on children’s health program

If Congress fails to reauthorize a popular health insurance program, it will cost the state big money. But unlike in some other states, New Mexico’s children won’t lose health insurance.

The Children’s Health Insurance Program, or CHIP, lapsed on Sept. 30. Since then, Congress has failed to agree on renewing the federally-funded program. This led states, including New Mexico, to prepare for the worst. Nationwide, 9 million children rely on CHIP-funded health health insurance.

Some states already sent notices to families, warning them to prepare for the possibility of losing coverage, but that is not an option in New Mexico. Instead, the state will have to pay more to make sure children of families who don’t qualify for Medicaid can still receive health insurance coverage.

Brent Earnest, secretary of the state Human Services Department, told the Legislative Finance Committee last week about the impacts of Congressional inaction on CHIP on New Mexico’s budget.

“New Mexico is a little different than some other states in that we don’t run a separate CHIP program,” Earnest said. “We use CHIP to expand eligibility to more kids and higher-income families in New Mexico.”

Because of this, he said, New Mexico cannot disenroll children, an option he acknowledged New Mexico likely wouldn’t consider even if it were possible.

He told the panel the state can probably fund the program through the end of June, which is also the end of the fiscal year.

Once that money runs out, however, the state will have to find another $31.2 million from somewhere, according to HSD estimates. That’s nearly half of the department’s entire request of $68.3 million in new money for 2018, according to the presentation to LFC.

Earnest believes Congress will be forced to act once the end of the program starts to impact families and end enrollment in other states.

But Rep. Antonio “Moe” Maestas, D-Albuquerque, was less optimistic. He warned colleagues they shouldn’t count on Congress to pass a CHIP reauthorization.

“I’m hopeful as well, but I don’t have any confidence that it’s going to happen,” Maestas said during the LFC hearing. “Although it supposedly has bipartisan support, at best it’s a political football in other bills.”

CHIP in New Mexico

The program is necessary for New Mexico families, said state Sen. Jerry Ortiz y Pino, D-Albuquerque.

“It really takes the issue of family income out of the picture for children’s health,” Ortiz y Pino told NM Political Report. “It essentially makes every kid eligible for the package of benefits very similar to the Medicaid package of benefits.”

“With our poverty and most of the children born on Medicaid, it’s critical access to healthcare to kids,” Rep. Debbie Armstrong, D-Albuquerque, told NM Political Report of the program.

HSD would not make anyone available for an interview about CHIP and a spokeswoman asked NM Political Report to send questions in an email. Instead of responding to those questions, the spokeswoman provided a link to the webcast of the December Legislative Finance Committee hearing and to an article on The Henry J. Kaiser Family Foundation website that briefly mentioned New Mexico.

New Mexico’s CHIP program provides funding for insurance for children in families who do not qualify for Medicaid and earn up to 305 percent of the federal poverty level. The Georgetown Health Policy Institute Center for Children and Families found 15,100 children received health insurance coverage because of CHIP in 2016. That is a relatively small number compared to the 414,277 children who receive coverage through Medicaid.

In 2014, there were 16,000 children covered by CHIP in New Mexico according to the National Academy for State Health Policy analysis of Medicaid and CHIP Payment and Access Commission data and in 2013, 9,368 children in the state were covered through the program.

Delegation support

If it were up to the New Mexico congressional delegation, CHIP would already be reauthorized.

Instead, the program is expected to be rolled into a year-end bill to fund the federal government.

“It is unacceptable that Republicans are putting 9 million children who rely on this health coverage at risk,” Sen. Martin Heinrich said in a statement to NM Political Report. “We must do all we can to improve the wellbeing of our state’s children, and one way to do that is by improving families’ access to affordable health care. We need to reauthorize CHIP now.”

His colleague, Sen. Tom Udall, spoke on the Senate floor in October about the importance of the program.

“No parent who is already in crisis because of a sick child should have to go through that,” Udall said. “CHIP was a bipartisan success story, I hope we can get back to working together on this.”

At the time, Udall spoke not not only about reauthorizing CHIP, but also Community Health Centers, the Special Diabetes Program for Indians and the Maternal Infant and Early Childhood Home Visiting Services Programs. He also expressed hope that they could do so “by Thanksgiving or earlier if we work together.”

In November, the U.S. House voted to extend CHIP funding for five years. Most Democrats, including both from New Mexico, voted against the bill because of strings attached, including using new fees for Medicaid, higher Medicare premiums for higher-income beneficiaries and money from a preventative fund to pay for the reauthorization.

Rep. Steve Pearce, the lone Republican in the delegation, voted for that bill.

“CHIP and other public health priorities are vital for highly rural and low-income communities. Often, these services are sole points of service for crucial child healthcare programs,” Pearce said. “I supported efforts in the House to provide essential funding for CHIP, and believe we must work to ensure communities throughout New Mexico can still have access to these programs.”

The southern New Mexico representative called it “disappointing” that the Senate did not act on the legislation.

Rep. Michelle Lujan Grisham, a Democrat, said “Republicans have held CHIP reauthorization hostage by insisting on cutting essential public health programs and kicking nearly 700,000 Americans off of their health care plans to pay for CHIP’s extension.”

“A long-term, bi-partisan, CHIP reauthorization should have been completed months ago, and Congress’s failure is causing many states to run out of funds,” she continued.

“I support a robust reauthorization of CHIP but I’m not willing to pay for it on the backs of other vulnerable people,” Rep. Ben Ray Luján said. He cosponsors a bill that would reauthorize the program for five years.

“Instead of acting on vital priorities, Republicans spent months playing politics and rushing to pass tax cuts that come at the expense of working families, while at the same asking senior citizens to pay for children’s healthcare,” Luján continued. “This is unacceptable. We must do better than this.”