Baker Administration Preparing To Stretch CHIP Dollars As It Waits For Congress

Health and Human Services Secretary Marylou Sudders has a Christmas wish: that Congress will again fund the Children's Health Insurance Program.

Lawmakers on Capitol Hill missed a September deadline to reauthorize the program, known as CHIP, and Sudders said at a Massachusetts Health Connector board meeting Thursday that the state will run out of its federal CHIP allotment in mid-January without action from Congress.

The state would be able to maintain CHIP coverage through the end of this fiscal year by taking "administrative actions," if it looks like Congress will ultimately reauthorize the program, Sudders said.

"CHIP has never not been reauthorized," Sudders said after the meeting. "It affects every state in the union, and it's children. There may be debates about coverage for other individuals, but this is about children and pregnant women, so I have some modicum of confidence that Congress will do the right thing, and there's good conversations in Congress right now about the CHIP program. That's my Christmas wish."

If Congress does not reauthorize CHIP, the state stands to lose an estimated $147.5 million in the fiscal year that concludes at the end of June, and $259 million annually starting in fiscal 2019 if MassHealth, the state Medicaid program, maintained the current program, according to the Executive Office of Health and Human Services.

Since Oct. 1, when the authorization ran out, MassHealth's CHIP funding has been a combination of carryover funds from fiscal 2017, and "redistribution funding" — unspent allotments from prior years — from the Centers for Medicare and Medicaid Services.

MassHealth is taking steps to make its existing funds available for use to cover spending needs if CHIP is not reauthorized until later in fiscal 2018, according to Sudders' office. MassHealth is claiming certain spending under Medicaid to reserve CHIP funding for populations that can only be claimed through CHIP.

Sudders said most CHIP participants are eligible for Medicaid and would stay on Medicaid if the CHIP funding was lost. The people "most at risk of having no coverage available to them" are 5,000 pregnant women on CHIP who are not eligible for Medicaid because of their immigration status, Sudders said.

Gov. Charlie Baker has repeatedly contacted members of Congress to urge CHIP reauthorization, most recently joining a bipartisan group of a dozen governors Tuesday in sending a letter to House and Senate leaders.

"In the absence of Congressional action, we have worked to protect coverage for children and pregnant women in each of our states, but we will need federal support to continue the program," the letter said. "Resources are nearly exhausted and some states already have begun to inform families that their children's coverage may end on January 31."