This week, Senator Orrin Hatch (R-UT) helped push a tax bill through the Senate that will cost about $1 trillion. At the same time, he lamented the difficulties of finding the money to fund the Children's Health Insurance Program (CHIP), which pays for healthcare for nine million children and costs about $14 billion a year — a program Hatch helped create.
A Sunday-morning tweet from MSNBC's Joe Scarborough quoting Hatch kicked off a dustup on Twitter over the Utah Republican's take on CHIP. Funding for the program — which was created as a joint effort between Hatch and Democratic Senator Edward Kennedy in 1997 — expired at the end of September; Congress has yet to reauthorize it. That puts health care for millions of American children at risk.
On Thursday evening, as the Senate debated the Republican tax plan, Democratic Senator Sherrod Brown (D-OH) asked whether there's "something we can do to get the children's health insurance program done."
Hatch's response, in a nutshell: Yes, we'll fund the program, but we're really short on money.
"We're going to do CHIP, there's no question about it in my mind. And it's got to be done the right way," Hatch said. "But the reason CHIP's having trouble is because we don't have money anymore, and to just add more and more spending and more and more spending, and you can look at the rest of the bill for the more and more spending."
This came as he advocated for a tax bill that, according to the Joint Committee on Taxation's latest estimate, will add approximately $1 trillion to the deficit even when adjusted for economic growth, and which disproportionately benefits corporations and the wealthy.
In his speech, Hatch also said he thinks CHIP has done a "terrific job for people who really need the help" and noted that he had advocated for helping those who can't help themselves throughout his Senate career. But, he continued, "I have a rough time wanting to spend billions and billions and trillions of dollars to help people who won't help themselves, won't lift a finger and expect the federal government to do everything." He blamed a "liberal philosophy" for creating millions of people "who believe everything they are or ever hope to be depend upon the federal government rather than the opportunities that this great country grants them."
It's been two months since CHIP funding expired, and Congress still hasn't acted
Signed into law by President Bill Clinton in 1997, the Children's Health Insurance Program provides coverage to children in low-to-moderate income families and to pregnant women. The percentage of uninsured children in America dropped from 14 percent when it started to 4.5 percent in 2015.
Congress last reauthorized the program in 2015 and was due to do so again by September 30, 2017. Except this time around, congressional leaders let that deadline pass. And while states contribute some money to the program, it is primarily funded by the federal government, which means its money will soon start to run out.
According to the Georgetown University Health Policy Institute Center for Children and Families, at least six states — Arizona, California, the District of Columbia, Minnesota, Ohio, and Oregon — are predicting they will run out of money by early January if CHIP isn't reauthorized. And six other states — Colorado, Pennsylvania, Texas, Utah, Virginia, and Washington — have said they'll take action and notify families their coverage is about to be cut off before the end of the year even if funding isn't running out yet.
There are some backstops in place. States can keep covering children through Medicaid programs or send children to the Affordable Care Act's marketplaces to buy coverage. But those aren't options everywhere, and it's likely some children will fall through the cracks regardless of whether Congress reauthorizes CHIP given the current uncertainty in funding the program.
"Every time one of those kinds of things happens, we have to retool our relationships with families," Steve Freedman, a University of South Florida health policy professor who sits on the CHIP board there, recently told Vox's Dylan Scott. "When you start fiddling with people's economic security, particularly their children's health care, that's a really sensitive place to screw around."
On Thursday, Hatch seemed to acknowledge the potentially disastrous consequences of the CHIP standoff. But what he failed to recognize is that, at least in some cases, the damage might already be done.