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Massachusetts health care — wonky, with a healthy dose of reality

Report - CHIP Critical To Kids' Health in Massachusetts (and the state budget)

Report - CHIP Critical To Kids' Health in Massachusetts (and the state budget)

April 8, 2015

Coverage for 130,000 children and pregnant women. A $166 million hole in the state budget. Those are the stakes for Massachusetts in the upcoming Congressional vote to extend federal funding for the CHIP program.

For over 17 years, CHIP has helped millions of children get the health care they need. CHIP keeps children healthy, allowing them to get consistent care and timely, appropriate treatment. The outline of CHIP was born in Massachusetts. In 1996, the state, with a strong advocacy push from Health Care For All, passed legislation expanding Medicaid and transforming it into the MassHealth program. Among the provisions was a substantial increase in coverage for children, funded by an increase in our cigarette tax. After the legislature overrode Governor Weld's veto of the bill, our law came to the attention of Senator Edward Kennedy, who took the idea and formulated the original federal CHIP law in partnership with Republican Orrin Hatch.

But, federal spending authorization for the CHIP program ends this fall. The U.S. House passed a bi-partisan bill in late March to extend funding for the program for an additional two years, attaching it to a fix of the Medicare physician funding system. The law also extends funding for community health centers, the Maternal Infant Early Childhood Home Visiting program, and family to family information centers. All Massachusetts Representatives voted for the bill. The U.S. Senate is expected to vote on the bill when it returns next week.

Now, the Mass Medicaid Policy Institute of the Blue Cross Blue Shield of Massachusetts Foundation released a report analyzing the impact of the federal CHIP program for Massachusetts. The report was written by Robert  Seifert of the Center for Health Law and Economics at University of Massachusetts Medical School.

The report lays out the stark impact on Massachusetts if CHIP funding were to end:

All told, if federal CHIP funding is not continued and Massachusetts opts to continue to provide coverage to all of the 130,000 children currently covered, it will do so at an additional cost of about $166.3 million in SFY 2016.

Alternatively, fiscal pressures could lead Massachusetts to amend its 1115 waiver to eliminate MassHealth coverage for as many as 58,000 CHIP children and to choose not to cover the 7,000 unborn children. Some of these children might obtain more expensive, less comprehensive coverage through an employer or the Health Connector, but a significant number of them could become uninsured. This would reverse a long-running trend in Massachusetts and tarnish what has been one of the state’s great health policy triumphs: reducing the number of uninsured children in the state to a minuscule level.

Today, there were some rumblings that the law that was overwhelming passed by the House (the vote was 392 to 37) may be in trouble in the Senate, mostly from conservative Republicans. We strongly support the federal extension proposal, and urge the Senate to support the bill. CHIP is critical for kids' health in Massachusetts, and for our state budget.

     - Brian Rosman