AAP advocates for immediate CHIP funding extension


Devin Miller    12 October 2017

Since the beginning of 2017, the Academy has been speaking out against numerous iterations of legislation that would jeopardize health care coverage for millions of Americans.Amid looming threats to the Affordable Care Act (ACA) and Medicaid, funding for another critical health insurance program faced a deadline on Sept. 30 the Childrens Health Insurance Program (CHIP). At publication time, Congress had not extended funding.In the days leading up to the deadline, senators attention was focused on a last-ditch attempt to repeal the ACA. The bill, from Sens. Lindsey Graham (R-S.C.) and Bill Cassidy (R-La.), included the same harmful policies as the legislation that was considered over the summer, and went even further in its attacks on Medicaid.After days of negotiations and fluctuating vote counts, the Senate decided not to vote on the legislation. While this was an important advocacy victory, efforts in Congress to extend funding for CHIP took a backseat.For the Academy, this missed deadline was unacceptable, and pediatricians continued to amplify the need for urgent action to extend the programs funding for five years.There is no disagreement among members of Congress that CHIP is a vital program for children that needs to be funded, said AAP CEO/Executive Vice President Karen Remley, M.D., M.B.A., M.P.H., FAAP, in a press statement following the missed deadline. The problem, which we often see in advocating for childrens issues, is one of benign neglect assuming, wrongly, that states can continue without renewed funding right away assuming, dangerously, that members of Congress will eventually come together to do the right thing but not making an urgent plan to ensure its so.CHIP stands on Medicaids shouldersCHIP provides health care coverage for nearly 9 million U.S. children from families who do not qualify for Medicaid and lack access to affordable private coverage. Although CHIP is authorized through 2019, Congress failure to extend the programs funding put into question continued access to health care coverage for those enrolled.According to a report from the Kaiser Family Foundation, 10 states were expected to run out of CHIP funding by the end of the year, and 32 states projected they would exhaust federal funds by April 1, 2018.CHIP is an important part of an integrated health care system. Along with private coverage, CHIP, Medicaid and the ACA have worked together to bring the insured rate among children to a historic high of 95%.CHIP is designed around childrens needs, offering age-appropriate benefits, including dental coverage and mental health and substance abuse services, which may not be covered by a familys employer-sponsored insurance.CHIP plans also include networks of pediatricians, pediatric medical and surgical subspecialists, and childrens hospitals, which are especially critical for children with special health care needs.The program has a long history of bipartisan support since its beginning in 1997. Most recently, the program was reauthorized in 2015 as part of the Medicare Access and Childrens Health Insurance Program Reauthorization Act. Notably, the reauthorization occurred on the final day of the Academys Legislative Conference in Washington, D.C., when pediatricians met with their members of Congress on the issue earlier in the day.Pediatricians speak outLeading up to the Sept. 30 deadline to extend CHIP funding and in the aftermath of Congress failure to act, AAP members were out in front, urging their lawmakers to take immediate action on a five-year funding extension.The Academy hosted a Day of Action on Oct. 4 to concentrate its advocacy outreach and coordinated this work with several other leading child health and advocacy organizations. To support this effort, the Academy created a toolkit for pediatricians and partner organizations with sample social media messages, talking points and additional resources they could use to add their voices to the chorus.The Academy also engaged leaders from chapters, districts, committees, councils and sections in these advocacy plans, encouraging broad dissemination within their networks.On the first day of action, pediatricians weighed in with calls to their members of Congress, and #ExtendCHIP was used more than 203 times on Twitter and Facebook for a total reach of 17 million people. The Academy is holding a second Day of Action on Oct. 11 to maintain the drumbeat of advocacy focused on CHIP funding extension.In addition, numerous op-eds from pediatricians were published in local newspapers, and AAP members were quoted in news articles about the need to extend CHIP funding without delay.The Academy also joined an advertisement with the Childrens Hospital Association and other organizations that was placed in The Hilland CQ Roll Call with the message to Congress, Time is up: Extend CHIP Now.Throughout the debate on CHIP, the Academys main message was that action to extend funding for the program for five years could not wait. Without certainty from Congress, states could be forced to make drastic cuts to their CHIP programs, such as slashing enrollment, reducing benefits and imposing higher costs for families who rely on the program.Children and families need to know that they can continue counting on a program essential to their health and lives, Dr. Remley said. Members of the American Academy of Pediatrics will continue to demand that of our elected leaders until we see real progress.

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