AAP advocates for immediate CHIP funding extension
DevinMiller, Washington Correspondent
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 Children’s 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 program’s 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 Lynda Young, M.D., FAAP, chair of the AAP
Committee on Federal Government Affairs, following the missed deadline. “The problem,
which we often see in advocating for children’s 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 it’s so.”
CHIP stands on Medicaid’s shoulders
CHIP 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 program’s 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 children’s needs, offering age-appropriate benefits, including
dental coverage and mental health and substance abuse services, which may not be covered
by a family's employer-sponsored insurance.
CHIP plans also include networks of pediatricians, pediatric medical and surgical
subspecialists, and children's 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 Children’s Health Insurance Program Reauthorization Act. Notably, the reauthorization
occurred on the final day of the Academy’s Legislative Conference in Washington, D.C.,
when pediatricians met with their members of Congress on the issue earlier in the
Pediatricians speak out
Leading 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
The Academy also joined an advertisement with the Children’s 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 Academy’s 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
“Children and families need to know that they can continue counting on a program essential
to their health and lives,” Dr. Young said. “Members of the American Academy of Pediatrics
will continue to demand that of our elected leaders until we see real progress.”