This fall. A decision on whether to renew the Childrens Health program. Remind us what this is and who is eligible. Chip is the Health Insurer just Childrens Health Insurance Program. It was started because there were a lot of uninsured children that were in families that earn too much to qualify for medicaid , but not enough to where private insurance would be affordable or even available in some cases. Maybe the parents work in were employersponsored coverage wasnt an option for the hall family. Congress wanted to make this commitment to covering kids into getting more kids covered. They start of the chip program and since that time we have now reached historic coverage levels for kids in the u. S. This is something we should be very proud of. We have 95 of kids covered in the u. S. And that is thanks in large part to the work of medicaid and chip and the commitment to covering kids in a bipartisan way. Guest what is host what is the price tag and how does it compare under the medicaid coverage for children . Guest the price tag on the policies and how Congress Might want to change in the future. For this year it cost about 14. 5 billion. It covers 9 million children. In terms of a perperson cost certainly relative to other sources of coverage can cost more perperson for example in the private market. You tend to pay a bit more even at the federal level. Compared to medicaid, medicaid is much larger. It covers 37 million children and cost a lot more. Around a lot longer. Medicaid tends to cover children are lower incomes and oftentimes with entire health care needs, robustd has a more bennett pediatric benefit because its understanding its covering this population with low income and high need. The chip benefit package depends state to state. It can be more based on private insurance models, recognizing children and that income range typically maybe 200 of poverty which would be about 40,000 for a family of three. Those families can afford a little bit more premiums, they have the benefit package reflects that. Host i want to invite viewers to join in. If your questions or comments. Republicans, 2027488001, democrats 2027488000, independents 2027488002. A special line for parents of chip recipients. That number is [captioning performed by the national captioning institute, 2027488003. Why is there action that needs to be taken . Guest initially when ship was started in 1997 it was for a 10 year period. In 2007 there were shortterm shift extensions. Eventually it was extended through 2009. From there to was extended through a couple of different vehicles. In 2009 the a 4. 5 chip extension 4. 5 year chip extension. That took through 2013. There were two two your extensions. One in the Affordable Care act with seven to 2015 and and most recently in the medicare and chip reauthorization act which took this funding up until september 30, 2017. We are just about a month away from no more federal funding for the Childrens Health Insurance Program and thats why Congress Needs to take action again to extended. Host how much action as this congress taken . How much is artie taken place . Are their meetings in the work or do they need to get this done and havent started much on. They have started. In years past theyve been able to move earlier and faster, for example with the renewal act, that was ahead of a similar deadline. This time around there been a lot of other debates going on in the health care field, which is limited congresss ability to focus on chip. All the attention to repealing a flake replacing before the care act has made it harder for congress to talk about their children Health Insurance program. We are approaching a deadline upon us. There have been steps taken. The energy and Commerce Committee which has jurisdiction in the house had a hearing on chip, the Financing Committee had a discussion over chip in the senate. They had a hearing scheduled in may but was rescheduled for september. Thats great to see that progress in going to regular order and the committee process. There is still a lot that needs to happen by september 30 and very few legislative days. It would be good to hurry up. Host you mention a house hearing back in june. This is michael burgess, some ofan talking about the concerns of chip and some of the issues of debate that congress is having as this reothers asian question looms. A little bit from adhering. As for the state Health Insurance program, or multiple points of consideration as of consideration as is the case with other federal insurance considerablere are concerns regarding the longterm sustainability of the program. Following the passage of the formal care act, the programs federal match rate rose an unprecedented 23 . Providing some states with as much as a 100 federal match. This increase in funding has aboutnge the program by shifting the nature of shared responsibility of the state Childrens Health Insurance Program to the federal government and making states more dependent on federal dollars. The issue is further competition by concerns raised by the Congressional Budget Office on the efficacy of enhanced trade. According to the bought office, and illumination would basically not impact coverage rates for children in the country while a continuation of the enhanced funding would add another 7. 5 Million Dollars to the deficit over the next five years, if no other policies were undertaken to offset the cost. Host i wanted to pick up on some of what was in that statement by michael burgess. How big of a stumbling block will this be to the reauthorization . Guest he hit on one of the controversial aspects which is bill,n 2015 in the macra it funding was extended and a policy of been put in place which increases the federal share of spending on chip was implemented and funded. That is a 23 percentage point increase in the match rate, which to step back for second and explain about what that means, chip is funded in part by the federal government and in part by State Government through a matching system. Traditionally the match rates has ranged from about 65 federal to about 82 or 83 federal share. That is a large increase. It has the effect of reducing the state share so states are putting in less dollars overall than they would before in the last two years. Its a question pending before congress now whether to continue to fund that enhanced rate. Were not too. States of artie completed a budget cycles so they have already have been banking on this money because of the timing coming around later. It does pose a problem for states. Data sort of relying on congress to continue that higher funding level and if congress were to change its mind, they would have to come back and have a special session, try to find money to fill that gap in the budget. Provisionntroversial in part because as you noted, the Congressional Budget Office said he didnt have any effect on increasing coverage for children, which i think raises another question about why was this enhance match implemented to begin with. It is really complicated of an issue. The underlying policy is that with so much change happening in health marketplace, there was a desire to have stability for children because theres been a longterm commitment to kids. As part of that there was a maintenance ever provision implemented in the Affordable Care act which requires states to continue to cover kids through september 30, 2019. With that they gave some additional federal funding for the Health Insurance program. If you atugh balance the federal level wants to approach additional requirements. That comes with providing additional funding for states. These two policies are intertwined and will be Something Congress has to think through whether it it is a provision through september 30, 2019 or extended beyond that and the same goes for the increased match rate. Whether to allow that to continue or shave it back. It is increased coverage for kids in some state. S. Maybe not enough to affect the baseline. In a handful of states that expanded coverage to children who otherwise would have to wait five years in order to qualify. States have this option to lift that fiveyear waiting time. States have also avoided cuts to medicaid because of that additional federal funding. Perhaps the best example is in arizona where arizona had closed to program and then decided reopen it once there was additional funding. Law have it tied into state that if there match drops below a certain rate, they close the program again. Alliance for democrats, republicans and independents as usual as well as 2027488003 for parents of chip recipients. We are having this discussion with kelly whitener. Florida, line for independents. Now the federal government is paying for all the childrens funds in other words and the state is not picking up their half of the deal . Is that your question, lenny . Caller yes. Guest the federal government paying more than they used to and in about 12 states it is the federal government paying 100 of the chip cost. In the rest of the states, states are still constructing a state share. It host does that concern you . Caller not really, i was tried to figure out why the states arent paying what they should be paying and trying to get off the federal government. Guest it was really a change in federal law. The federal law says that states werent able to cut back on eligibility or make other changes to their program, which limits ways that states can balance their budget. In turn, the federal government officer that Additional Support to make that easier to handle. Tommy is an independent. Good morning. Caller good morning. It was my belief that the children of this country to be taking care of and if the state cant do it, then perhaps corporations need to or someone because the children of this country are future. Like abandon our children we are, they will become our oppressors. We need to take care of our children. In a way that is healthy, wealthy and wise. I look forward to your comments on this matter and have a blessed day. Thank you and i agree that covering children is really important. There is a lot of research looking at Important Roles in having Health Coverage as a child leads to an your life. For example it leads to better health, which is not surprising. It also has implications beyond health care. So having Health Coverage as a child leads to better educational outcomes and they are more likely to finish high school and go to college. It also leads to better economic overtime. They are more likely to grow into adults with higher jobs and become taxpaying citizens. I agree its really important to cover children and it has been a , really for our country highlighted since 1997. Host a chart on that from the Kaiser Family foundation showing coverage among descendents of the population. The orange line on this chart through 2006 is the coverage range for children. 5 in 2016 down from 14 in 1997. 64t compares to adults 18 to at 12 in 2016 down from 19 in 1997. Org. Can go to kff. Kathy from virginia, line for democrats. Caller thank you for taking my call. I have a simple question. In the 70s when my children were babies, there were free clinics and they were in abundance. Immunizations, they went in if they had something wrong. I remember my oldest got bit by a dog and got stitches and got shot im out of touch with all that. Nature ofill the things out there or is that something that the states could be involved in . Maybe bringing back is free clinics at least for the immunizations and the things like that. There are still free clinics available and terms of Services Offered for free. The chip program for example, even though states have the discretion to impose cost sharing and require copays or premiums and things like that, they are not allowed to impose any costsharing on things like immunizations, recognizing its important to have that preventative primary care for immunization and things that they are really committed to as a country. There is a low barrier to entry there. Some families can access those without high costs or any costs. Host mary is on a line for democrats. Caller good morning. I was wondering of all the children the united states, how many are covered by private insurance versus medicaid or chip . Insurance for the parents employment or because their parents by the men policy. Does your guess have those numbers . Guest it looks like you have a chart. Host that exact effect. The nation 78. 2 million children back in 2015. Medicaid and chip picks up 39 of the nations children. uninsured other Insurance Programs picked up 2 . Do you want to talk through some of those numbers . Guest we rely on that chart a lot. If you look at different segments of the child population, the numbers shift around. This is exactly right for children overall. If you were to look at children under 200 of poverty, the numbers shift and you see about two thirds of children arent covered by medicaid and chip are covered by medicaid and chip. Young children, children under the age of six, almost half are on medicaid and chip area it depends on the category of child who are looking at, but that is exactly right. We have that special line test lines we have that special line for parents of chip recipients. I want to ask you and what that this administration is proposed for the program and what sort of changes of a looking for. We sigh little bit in the Budget Proposal from earlier this year. Guest the budget included a number of other changes to the program. For example, eliminating the funding earlier. Also eliminating the funding we talked about. Also more dramatically limiting states abilities to cover children above 250 of poverty. Today states are able to set their income eligibility levels for children in chip and they have done so to a wide range. Most states cover children over 200 of poverty or at 200 of poverty. Some states covering children up to 300 400 of poverty. The meeting covered level is 255 of poverty. The Budget Proposal would limit that ability to cover children at those other income levels and that would cap at 250 . Host west haven, connecticut, line for independents. Seeing that youre a Health Insurance advocate, what do you think about people who choose to be responsible and not have children. What about the people that go ahead, they are just tried to take care of themselves, why is there all this money available for people who maybe they can afford to have kids. Maybe they shouldnt. I understand that we have to take care of all these kids, but what about your role or the Health Insurance agency or Even Health Care in general. It doesnt seem like anyone thing is getting done. It just seems like its becoming more and more of a problem and its becoming a taxpayers burden. Guest it is an interesting question. I think there has been over time a different perspective about the role of government in providing health care, the role of the private market in providing health care certainly its an individual decision about whether or not to have children. I think the caller raises some about generally what value, its not really something i can speak to. Childrenhat covering improves their outcomes over time both in health and education and jobs. We see that is something that really benefits everyone and therefore is a worthwhile investment. Jay is in charleston, south carolina. Line for democrats. Caller im a big fan of the show and how objective it is. I want to keep it brief. Fordefinitely an advocate expanding the Health Insurance. If obamacare isnt perfect, we just need to improve the ways that is not helping people and we should keep it in place on a policy that all the policies that worked. It is the bigger picture, i was listening to some of the comments that young lady made earlier and im a bit concerned. As far as being responsible, as far as not having children, im in defense come my children save my life. It was a lot of things that i wasnt doing and they definitely put things in perspective. Its the bigger picture. I believe its the thank you. Is there currently any debate to. So there is room for improvement there, but i would say the discussion so far has been about making sure ways adequately funded in a reliable for states. For loraine, line republicans, go ahead. Caller yes. To be an upper middle class citizen until obama got in office. Obamacare, i didnt keep my same doctor, i have switched. Doctors in the last three years. I am in the system correctly. Train wreck. Im really kind of livid about welfare er stood in a line until now and i was put there by barack obama. Host can i ask you, since were talking about the Childrens Health Insurance Program, are with the expansion of the federal role that the ederal government paying more money to states and picking up more of this specific program, Childrens Health insurance. Caller my tax money helps those children. Worked all my life and im what pt now because of obama did in office for the last eight years. Host loraine, in arizona. Hopedale, line for democrats. Good morning. Caller yes, good morning. And i am someone, im very healthcare, out the i dont understand why that it passed or something being done. Hardly get my Blood Pressure pills that i need. Linda talking about health care, not exactly Childrens Health Insurance Program. Can you tell us about your program at Georgetown Center ty, what the specifically does and some of on . Reports that you work guest sure, the center for we are a nd families, small team, but a mighty one, i think. We do research and policy mostly medicaid and chip, trying to understand how the programs work, how they different from state to state, how potential changes at impact them. Evel all with the lens of thinking about children and families. Think about the Important Role that Health Overage plays for kids and recognize children have families, they have aunts, grandparents helping take care of them. We try to think about bigger family coverage question and make sure, you know, were looking from that well, and not squarely focused on children. Ccf. Georgetown. Edu. Waiting in columbia, south louie, go ahead. Caller i want to know if there expand the chips program. Im still single, i want to know expand the oing to program. I hope they dont make cuts to the program, thats all i really want to know about the program and such. Call. Appreciate the a good place to end, your prediction for what happens end month . Guest my optimistic prediction, congress will act to extend chip funding and they will do so recognizing that with a lot of haos happening in health care generally it is important to provide stability to states and families and provide for a long funding extension, five years or more, and to just allow states to then have time and bility to improve quality, focus on delivering system changes they want to make and make chip a Better Program for is today. Han it host kelly whitener, center for families, d appreciate your time. Come back again. Guest thank you. Host up next on Washington Well be focusing on new report for competitive nterprise institute discussing reorganizing and shrinking the size of the executive branch. Us in rray will be with just a minute. Every month book t. V. On cspan 2 features an indepth with an author about their writing career. Mata xus, 3 rdz, eric if you can keep it, his other amazing grace, plus a autobiographer. Author maurine dowd will world, er book, bush and the year of voting lewis ous, and michael will talk about his books, including the undoing project, big short and the new new thing. Join us for in depth, the first of the month noon eastern. That is book t. V. On cspan 2. Cspan, where history unfolds daily. 1979, cspan was created as a Public Service by americas companies and n is brought to you today by your cable or satellite provider. Washington journal continues. Host iain murray, vice Competitive Enterprise Institute, i apologize, joins us to discuss a new report that that organization has done focusing reorganizing the executive branch. First, remind us what the Competitive Enterprise Institute is. Guest Competitive Enterprise Institute is essentially the the u. S. Hink tank in focused primarily on regulatory affa
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