The Honorable Mitch McConnell
Majority Leader
U.S. Senate
Washington, D.C. 20510
The Honorable Paul Ryan
Speaker
U.S. House of Representatives
Washington, D.C. 20515
The Honorable Charles Schumer
Minority Leader
U.S. Senate
Washington, D.C. 20510
The Honorable Nancy Pelosi
Minority Leader
U.S. House of Representatives
Washington, D.C. 20515
Dear Speaker Ryan and Leaders McConnell, Pelosi, and Schumer:
On behalf of the nation’s governors, we urge immediate action on the Children’s Health Insurance Program (CHIP) and other important health care programs before the end of this calendar year. Critically important health care safety net services – including CHIP, Community Health Centers, and home visiting – regrettably expired on September 30th. These disruptions have not been without consequences, and we write to convey that further delay into 2018 will only compound the issues facing our states and vulnerable citizens.
In the case of CHIP, governors have written to Congress about the importance of children’s health coverage. CHIP is a Congressional success story to be celebrated – with the un-insurance rate for children age 18 and younger across the country dropping from 14.9% to 4.8% since first enacted. And although the program has had broad bipartisan support in past Congresses, the expiration will result in three states and four territories losing all federal CHIP support in December. Absent congressional action, states will be forced to take steps including the notification of thousands of families of the loss of CHIP health care coverage. Taking steps to avoid those worst-case outcomes places a tremendous administrative and financial burden on states and sows confusion among vulnerable populations.
Respected analysts like MACPAC indicate that failure to pass a CHIP reauthorization this year will spread that uncertainty to families and governments in 28 states in the first three months of 2018 and all but two states in the first six months. The positive news is that both chambers have taken affirmative steps towards reauthorizing the program. Recently, the House of Representatives passed the Championing Health Kids Act, and in the Senate, Finance Committee Chairman Hatch and Ranking Member Wyden have come to a bipartisan agreement – both proposals would fund CHIP for the next five years. Leadership from your offices is needed to arrive at mutually agreeable funding sources without further delay.
A second health care priority for governors is community health centers. These centers serve over 25 million people in all 50 states and the US territories. Yet with the annual discretionary appropriations for the Community Health Center Fund having also expired September 30th, these centers are facing increasingly difficult decisions about how to provide services to community members, often regardless of insurance status or ability to pay. Federal funding provides more than 70% of overall center funding, and one in six of the centers have budget periods that begin on January 1st, 2018, jeopardizing health access and jobs in struggling communities.
Lastly, states are closely watching the fate of the Maternal, Infant, and Early Childhood Home Visiting program (MIECHV). This home visiting program is a cornerstone of evidenced-based public policy that helps states build a future for low-income and middle-class children. Unfortunately, in addition to a lapse in federal funding, the House-passed bill for MIECHV includes a matching requirement for states. That requirement jeopardizes the future of the home visiting program by subjecting it to overburdened state budgets.
Meeting the federal commitment to these expired programs soon will avoid unnecessary disruption to the health care needs of millions of Americans in the New Year. Thank you for considering the urgent needs of states and families. The above health programs and more deserve to be resolved in end of the year negotiations.
Sincerely,
Governor Charlie Baker
Chair
Health and Human Services Committee
Governor Kate Brown
Vice Chair
Health and Human Services Committee
