Children's Health Insurance Program (CHIP) is vital for kids' wellbeing

September is a big month for kids – not only are they starting or heading back to school, but this year they also are taking center stage in Washington as Congress heads back from its own summer recess. Funding for the Children’s Health Insurance Program (CHIP) will expire at the end of September, meaning Congress must act swiftly to ensure continued, comprehensive medical and dental coverage for our nation’s children.

Nationwide, CHIP covers approximately 9 million uninsured kids (and in some cases, pregnant mothers) in families with incomes that are modest but too high to qualify for Medicaid. 

States administer the CHIP program in different ways. Your state may have a separate CHIP program, combine the CHIP and Medicaid programs, or include CHIP within Medicaid expansion initiatives. Although administered by states in a variety of ways, the federal government provides matching federal funds to all states and that funding is vital to the program’s continued success.

Historically, CHIP reauthorization and funding have enjoyed bipartisan support, with members of Congress working together to guarantee health care coverage for vulnerable children. However, with the hotly-contested debates over Affordable Care Act repeal and replace legislation, securing the future of the CHIP program may prove significantly more challenging this time around…

Congress must tackle a significant number of important issues in short order this September. 

Addressing the debt ceiling to avoid a government shutdown, authorizing Hurricane Harvey relief, and handling a Trump administration proposal to privatize air traffic control are all at the top of the list. But Congress cannot lose sight the importance of CHIP. 

Without a long-term solution, states will be left with uncertainty over the future of their health care programs for kids. If CHIP funding is not renewed, or not renewed by the end of the month, states will be forced to make difficult decisions regarding the enrollment of the children in their programs. Without this funding, some children will be left without any form of medical or dental coverage.

We have seen over time that coverage leads to care and access to appropriate dental care is vital for children. In particular, tooth decay, the most common chronic disease among children, is degenerative without treatment and prevention, and research shows poor oral health impacts school performance and attendance.

But CHIP’s importance extends beyond oral health. 

For example, recent research indicates that treatment of gum disease can lead to better overall health management—as evidenced by lower health care costs and fewer hospitalizations—among people with common health conditions, such as type 2 diabetes. Ultimately, Congress must understand the gravity of their decision – coverage for children positions them well for a lifetime of optimal health and success. Don’t let politics put this at risk. Instead, let’s collaborate across party lines to quickly develop a sustainable plan that provides effective coverage for children and mothers in CHIP.

September 2017 marks the start of school and the start of what could make or break our children’s futures. This month is about ensuring our next generation is well-positioned to achieve optimal health throughout their lifetimes. As an organization committed to improving the oral health of all, DentaQuest strongly urges Congress to work together on CHIP funding and reauthorization in time to protect these vulnerable populations.

Make sure your voice is heard! 

Look up your Representative or Senator and ask them to renew CHIP funding and support long-term, sustainable solutions to protect our children’s health care.

Friday Federal Roundup: CBO, CHIP, and More

As a partner to states and the largest Medicaid / CHIP dental benefits administrator in the country, we at DentaQuest must stay updated on the latest health care policy trends - in large part because anything in the health space affects the oral health space.

Recent federal health reform proposals could have significant implications for Medicaid programs, exchange populations, and oral health coverage for low-income families. We keep our employees apprised of the latest happenings in Washington D.C. with weekly federal newsletters, and thought this week was particularly relevant for more than our staff.

Here’s this week’s newsletter.

CBO Releases Report on Subsidies 

According to a report released earlier this week by the non-partisan Congressional Budget Office (CBO), insurance premiums for ACA plans would rise 20 percent next year and in some areas of the country, people would not have any insurance options if the Trump administration scraps key ACA subsidies. Trump has repeatedly threatened to pull the ACA subsidies, particularly since Congress failed to pass repeal and replacement legislation before the summer recess. CBO’s analysis also found that eliminating the payments would increase the federal deficit by $194 billion over a decade because of higher spending on premiums subsidies. Trump must decide by early next week whether or not to make next month’s payment.

Congress Turns Attention to CHIP

Funding for the Children’s Health Insurance Program (CHIP) expires September 30th. With Congress out on recess, this leaves few legislative working days to ensure that nearly 9 million children maintain their medical and dental coverage. While CHIP reauthorization has historically been a bipartisan issue through the years, the hotly-contested debates over ACA repeal and replacement have left state officials anxiously awaiting assurances from Capitol Hill that 2017 will be no different. We will continue to monitor federal discussions on the future of CHIP and advocate where possible for the vital inclusion of dental coverage in reauthorization efforts.

Trump Administration Encouraging Medicaid Redesign Efforts, State Innovation

As Congress takes a pause on repeal and replacement efforts while they are on recess, states are looking to the Trump administration in the interim for more regulatory flexibility. CMS is expected to soon approve a Medicaid waiver from Kentucky which among other things would require most Medicaid-eligible adults to work as a condition of receiving coverage. Arizona, Arkansas, Indiana, and Maine are considering similar work requirements. HHS Secretary Tom Price and CMS Director Seema Verma have both expressed that they are in favor of such Medicaid redesign proposals.

Last month Alaska became the first state to get increased flexibility from the administration to prop up its individual marketplace with a reinsurance program. Minnesota, New Hampshire, Oklahoma, and Oregon are some other states that have already filed or are considering similar waiver proposals to submit to CMS.

HHS Proposes to End Obama-era Payment Programs

HHS Secretary Price has announced plans to eliminate two Obama-era Medicare bundled payment programs and scale back on a third. This proposal would cancel initiatives that make hospitals more accountable for the cost of certain joint replacement surgeries and cardiac care, and shrink an existing program covering hip and knee surgeries. This is considered a victory for providers who oppose requirements to participate in new payment models. We will continue to monitor whether or not HHS will take further action to roll back requirements in order to slow down the transition to value-based reimbursement structures.

‘Action for Dental Health’ in Congress

While we all paid close attention to health care in the Senate last week, the House Energy and Commerce Committee made a critical, yet mostly overlooked step to advance oral health for at-risk populations.

On July 27^th, the Committee unanimously passed HR 2422, or the Action for Dental Health Act of 2017. This bill calls for Congress to authorize additional oral health promotion and disease prevention programs to help at-risk populations struggling to obtain appropriate oral health care.

The bill points out that more than 181 million Americans will not see a dentist, but almost half of people ages 30 and older have some form of gum disease and nearly a quarter of children under age 5 already have cavities. 

As we at DentaQuest well know, caries is the most prevalent chronicdisease among children and can be prevented. What’s more, we see time and again that Americans of all ages are in desperate need of access to oral health care - Missions of Mercy like the one in Wise County, Va., is a great example. Both the Washington Post and The New York Times covered the July event, for which thousands of people come from miles away and lineup for hours and even days just to get access to dental and other services.

If this new legislation passes through Congress, the Centers for Disease Control and Prevention will award grants and collaborate with states, counties, public officials, or other stakeholders to implement a variety of initiatives.

These activities could include oral health programs that:

·         more broadly use portable/mobile dental equipment;

·         facilitate the establishment of dental homes;

·         eliminate geographic, language, cultural, or other barriers to care;

·         reduce the use of emergency departments for dental conditions; and

·         provide dental care to nursing home residents.

It is exciting to see bipartisan support for dental care initiatives that have tremendous impacts on the oral and overall health of patients. This type of work will drastically improve the health of Americans. And it has the ability to address the estimated $2.6 billion in free care that dentists currently deliver, as well as the nearly $2.1 billion spent on dental cases in hospital emergency departments – 80 percent of which could be treated in a dental office for roughly $4 million total, according to the bill.

Bipartisanship like this must continue and we urge legislators to make oral health a critical component of any health reform legislation that passes through this Congress.