While Congress failed to pass legislation that would “repeal and replace” the Affordable Care Act (ACA) by the September 30 deadline (for a budget reconciliation bill with a simply majority in the U.S. Senate), the dominance of repeal efforts in the preceeding weeks resulted in two critical health care programs expiring September 30, 2017 – the Childrens’ Health Insurance Program (CHIP) and funding for the nation’s community health centers.
Essential Coverage for California Children
CHIP is a health coverage program for low and moderate income children jointly funded by states and the federal government. CHIP currently provides health coverage for 8.9 million children, including more than two million children and pregnant women in California (1.4 million at any one time). CHIP offers affordable, comprehensive, child-appropriate coverage for eligible children.
CHIP “sits on the shoulders” of Medicaid (Medi-Cal in California) which, in California, provides coverage to children in the lowest income families below 138 percent of the federal poverty level (FPL), or $24,600 for a family of four. CHIP covers children from 138 FPL to 266 FPL (up to $65,436 a year for a family of four). Approxmiately 5.7 million children rely on coverage through Medi-Cal, the state’s health coverage program financed by Medicaid and the Children’s Health Insurance Program (CHIP). California uses CHIP funds to finance coverage for roughly one-quarter of children enrolled in Medi-Cal.
According to the Kaiser Family Foundation, California is one of ten states that expect to exhaust current CHIP funding by the end of 2017.
California’s Safety Net of Community Health Centers
Federal grants represent a key source of funding for the nation’s Community Health Centers (CHCs). The federal Health Center Trust Fund includes both annual discretionary and mandatory funding. The mandatory portion fo the funding sunset on September 30, 2017.
According to the California Primary Care Association (CPCA), which represents community clinics and health centers in California, the state could lose over $300 million in federal funds if Congress does not act to extend the funding. Today in California more than 1,200 federally funded CHCs provide comprehensive primary, dental, behavioral, optometery and chiropractic services to more than 6.2 million people – 1 out of every 7 Californians – regardless of patient ability to pay. CHCs provide health care services to Medi-Cal and privately insured patients and offer services on a sliding fee scale for individuals who are uninsured or underinsured.
In addition, funding also expired for two programs CHCs rely on to ensure a stable workforce, the National Health Service Corps (NHSC) and the Teaching Health Center (THC) Program. CPCA notes there are 770 NHSC scholars in California who receive scholarships or loan repayment assistance to serve in low-income communities. California is also home to six of the 60 federally funded THCs in the country which serves as accredited community-based primary care health professional training programs. The delay in funding for these programs could impair the ability of THCs to participate in the fall medical school recruitment process. Failure to reauthorize funding for THCs could worsen California’s existing primary care provider shortages.
CHIP and CHCs are Building Blocks of Access to Care for Low-income Californians
CHIP and CHCs are essential programs for low-income and uninsured Californians in urban and rural areas of California. If Congress does not reauthorize these programs, California will face significant additional state costs and serious challenges to provide services for low-income and uninsured families.
You may want to contact your Congressional representative to let them know what you think needs to happen with these crticial health care programs. Stay tuned.