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In Ongoing CHIP Debate, Coverage Does Not Equal Care, Says Citizens’ Council for Health Freedom

States Should be the Back-Up for Program, Not the Federal Government


ST. PAUL, Minn.—A bone of contention within the many current health care debates is the funding of the federal Children’s Health Insurance Program (CHIP). No one wants to see kids go without health care, but government health care for children is not the best answer, says Citizens’ Council for Health Freedom (CCHF,

“It’s been 100 days since CHIP funding expired, but Congress authorized $2.85 billion to fund the program through March 31,” said CCHF co-founder and president Twila Brase. “The expired CHIP issue is an opportunity to rethink the continual expansion of federal coverage for America’s children. CHIP is simply an expansion of Medicaid, and builds individual and family dependency on taxpayer-funded government entitlement programs.”

CHIP was established in 1997 to be a state-federal partnership, but funding responsibility has primarily shifted to federal taxpayers, Brase reported. In 2016—when 8.9 million children were enrolled in CHIP—the federal share was $14.4 billion and the states chipped in only $1.17 billion, for a total of nearly $16 billion from taxpayers.

“Coverage for children is a state issue, not a federal issue,” Brase said. “And often forgotten, are the exorbitant sums of money health plans are making from these federal government programs. Even more importantly, ‘coverage’ from government programs does not equal ‘care.’ Children in Medicaid/CHIP are three times more likely to have difficulty getting a referral to a specialist than privately insured children (84 percent vs. 26 percent), according to the Kaiser Family Foundation. Additionally, as CHIP expanded, private health insurance for children decreased, and health insurers in 34 states stopped selling child-only insurance as a result of the federal Affordable Care Act.”

Brase added that by 2012, 25 states had taken action to require or encourage child-only policies. States, she said, should continue efforts to make affordable child-only indemnity (non-health plan) policies affordable and available. Unfortunately, the ACA requires states to maintain pre-Obamacare eligibility levels of CHIP enrollment through September 2019 or lose Medicaid matching funds, meaning they cannot adjust enrollment or end programs.

“Congress should repeal the ACA’s prohibition against catastrophic coverage and the CHIP maintenance of effort requirement to ensure that levels of state and local funding remains consistent from year to year,” Brase said. “Federal officials have been paying states from a redistribution fund to keep CHIP going, but states should be the back-up for the program, not the federal government.”

At the close of 2017, the federal government held nearly $3 billion in unspent CHIP monies in a “redistribution fund” that doles out funds in one-month increments to all states with a capped total share and according to expected shortfalls, Brase added. This fund is being used to cover the expiration period while waiting to see if Congress will reauthorize funding.

For more information about CCHF, visit, its Facebook page or its Twitter feed @CCHFreedom. Also view the media page for CCHF here. For more about CCHF’s initiative The Wedge of Health Freedom, visit, The Wedge Facebook page or follow The Wedge on Twitter @wedgeoffreedom.