Dysfunctional Republicans CHIP away at kids’ health care

Budget Director Mick Mulvaney holds up a copy of President Donald Trump's proposed fiscal 2018 federal budget. His $4.1 trillion plan for the budget year beginning Oct. 1 generally proposes deep cuts in safety net programs, including Medicaid and the Children's Health Insurance Program.

In this May 23, 2017, photo, Budget Director Mick Mulvaney holds up a copy of President Donald Trump's proposed fiscal 2018 federal budget as he speaks to members of the media in the Press Briefing Room of the White House in Washington. The plan for the budget year beginning Oct. 1 includes deep cuts in safety net programs, including Medicaid and the Children's Health Insurance Program. (AP Photo/Andrew Harnik)

Let’s do a pop quiz: Amidst all his latest tweets about the NFL, ESPN, “Liddle Bob Corker,” the “Fake News Media,” The Wall, and the purportedly brilliant job he’s doing in Puerto Rico, how many times has Trump worked his thumbs into a rage about the cancellation of the federal health insurance program that covers nine million kids?

It’s somewhere between zero and never. Big surprise.

Could there possibly be a better example of the dysfunction of all-Republican rule, that the highly successful Children’s Health Insurance Program — enacted with strong bipartisan support 20 years ago, and having slashed the share of uninsured low-income kids from 14 percent to five percent — would be allowed to simply expire on Sept. 30? Did the irresponsible congressional Republicans truly believe that nobody would notice?

I doubt that Trump ever noticed, because he’s a policy dolt who’s mostly focused on bright shiny objects. But those of us who value compassionate governance couldn’t help but marvel at the cruelty of Republicans who seem not to care a whit about putting nine million kids’ health in peril. And yet they’ve done so.

CHIP has long been a success story; at passage, it was championed by a passel of Senate Republicans and everyone from the Children’s Defense Fund to the Girl Scouts. It provides comprehensive coverage (routine checkups, dental care, immunizations, prescriptions) to kids whose families make too much money for Medicaid but not enough to afford private insurance. Since these kids live everywhere, red states as well as blue states partake. Last year the feds spent $13.6 billion on CHIP, and if that sounds like a lot at first glance, just remember that the price tag for the disastrous Iraq war averaged $10 billion a month.

So why did the Republican Congress allow the kids’ program to expire? Easy answer. All summer long, and well into September, they were so fixated on their failed crackpot quests to kill Obamacare (and thus destroy health coverage for roughly 20 million) that they didn’t leave themselves any time (or sufficient interest) to renew CHIP and protect nine million. Weeks before CHIP was allowed to expire, a kids’ health advocate — Joan Alker, director of Georgetown University’s Center for Children and Families, told a press briefing, “This is ridiculous. We’ve never had a situation like this before.”

But it’s easily explained, because we’ve never had craven non-governance like this before. Some states’ CHIP allotments are already running out. Minnesota and Utah are reportedly in the worst shape, 27 more states — including Pennsylvania — will deplete their money by early ’18, and most of the rest — including New Jersey — are due to run out by next summer. It’s ironic about Utah, because the red state’s senior senator, Orrin Hatch, partnered with Ted Kennedy to champion CHIP in 1997. He has described the program as “a moral responsibility,” but this summer he couldn’t get the Republican Senate to focus on a renewal measure.

This is what happens when you hand the reins of government to a right-wing party that doesn’t believe in government. Without getting into the policy weeds, here’s how tribal dysfunction works:

Hatch is currently scrambling to get CHIP renewed before most states start running on fumes (roughly 175, 000 kids are affected in Pennsylvania), and so far he has coaxed the Senate Finance Committee to say OK. But then, last Wednesday, the issue went to a House committee. And you know what the Republican House is like.

Republicans said that CHIP shouldn’t be re-financed unless funds were saved somewhere else in the budget; to offset the cost of CHIP, they want to use it as a bargaining chip. They suggested that its money could come out of Medicare and Obamacare. That’s a fascinating argument, in light of the fact that Republicans are currently pushing for a tax “reform” plan that features massive tax cuts for corporations and high-income Americans, tax cuts that would add hundreds of billions to the budget deficit.

Short version: When the issue is kids’ health, Republicans care about red ink; otherwise, the spigot is open. The upshot is that even if CHIP eventually gets renewed (not a sure bet), it’s not likely to happen before the usual budget fireworks at year’s end. By then, hundreds of thousands of kids, at minimum, risk becoming collateral damage.

Dorothy R. Novick, a pediatrician at Children’s Hospital of Philadelphia, lamented back in early August, when the expiration clock was already ticking: “It has been been 20 years since I’ve had to tell a mother she had no options for insuring her child.” I guess she didn’t get the memo that Republicans are making America great again.

Want a digest of WHYY’s programs, events & stories? Sign up for our weekly newsletter.

50% of WHYY’s funding comes from donations made by people just like you.