Not more than six months ago, the federal government for the first time in decades failed to re-authorize the federal Children’s Health Insurance Program (CHIP), which provides affordable health coverage for about 9 million children in the United States. Child advocates breathed a sigh of relief a few months ago when Congress finally reauthorized the program.
Now, CHIP is again the subject of efforts to curb federal spending. This week, President Trump announced an effort to cut $15.4 billion out of the $1.3 trillion spending bill Congress passed in March, using a process called “rescission”.
Budget rescission – used by Congress itself but rarely by presidents (Clinton was the last to do so) – is when money that has been appropriated but not spent is withdrawn.
Almost half of rescission request – $7 billion – would come from money appropriated for CHIP. Two billion of that is earmarked for the Child Enrollment Contingency Fund, which covers emergencies including circumstances in which enrollment exceeds expectations and federal dollars are insufficient to cover the added costs.
The Trump administration does not believe the request would harm the program, but child advocates are skeptical. From Sept. 30, 2017 to Jan. 22 of this year, the federal government allowed CHIP funding to lapse for the first time since the program was created in a bipartisan effort in the 1990s.
During that time, the state of Missouri was able to continue coverage of children under its implementation of CHIP, a program called MO HealthNet for Kids. This was accomplished through unspent funds.
To be clear, our state did not draw from the federal Child Enrollment Contingency Fund, according to records from the Centers for Medicare and Medicaid Services (CMS). Also, officials with the state Department of Social Services said they had no information on if the budget-rescission request would affect MO HealthNet for Kids. But the experience arguably shows that emergencies and shortfalls can happen.
The president’s budget rescission requires Congressional approval to proceed. Appropriations committees in both the House and Senate have 25 days to approve it. Then, it would need to pass a simple majority vote in both chambers.
As a child-advocacy organization, the Missouri Coalition of Children’s Agencies is concerned with precedent set by this action, if Congress approves it. Dollars earmarked for children’s health – even those dollars saved for rainy days – should be among the last places we look for savings in the federal budget.