Despite the best efforts of Republicans in Congress, the Affordable Care Act apparently will survive this year. But that does not mean the nation’s health care system is robust.
Witness the Children’s Health Insurance Program. When GOP leaders took up consideration of the Graham-Cassidy plan last month in a last-ditch effort to scuttle the Affordable Care Act — colloquially known as Obamacare — they halted progress toward renewed funding for CHIP, which helps provide coverage for 9 million children from low-income families across the United States.
Congress missed a Saturday deadline for funding the program, leaving states with only money from the previous budget cycle. Washington officials say CHIP funding will be exhausted by the first quarter of 2018; in Oregon, money is expected to run out by the end of this year.
Since the Children’s Health Insurance Program was established in 1997, the uninsured rate for children has dropped from 13.9 percent to less than 5 percent, making it one of the success stories of U.S. health care. Now, barring emergency legislation that ties the program to some other funding, it has been endangered by legislative incompetence.
Some conservatives have argued that CHIP should not be regarded as an entitlement and should be subject to budget cuts. This is shortsighted; instead, the program should be viewed as an investment. Providing health care for children helps prevent afflictions and habits that can linger for a lifetime and result in even greater costs down the road. The program helps provide economic stability for low-income families, and improved health has been linked to improved academic performance for young students.
Meanwhile, President Donald Trump failed to notice the irony when he declared Monday to be “Child Health Day” and wrote, “How we treat our young people is a fundamental test of who we are as a society.”
None of that, apparently, was as important to Republicans in Congress as an ill-fated attempt to repeal Obamacare. As Senate members tried to gin up support for the Graham-Cassidy bill — which ultimately did not come up for a vote — that legislation drew attention away from other health care efforts.
Another victim of Republicans’ single-mindedness was a push by Sen. Patty Murray, D-Wash., and Sen. Lamar Alexander, R-Tenn. As leaders of the Health, Education, Labor and Pensions Committee, they are seeking to strengthen the Affordable Care Act.
While Republican attempts to repeal the law have received much attention, efforts to simply undermine it often have flown under the radar. The length of this year’s enrollment period, which begins Nov. 1, has been cut in half; the website Healthcare.gov (Washington uses its own exchange) will be shut down during several key enrollment times; and the budget for advertising the exchanges has been slashed by 90 percent. Instability in the Affordable Care Act has contributed mightily to enormous premium increases for the coming year.
Murray and Alexander have held hearings with insurers and health care providers, recognizing the need for information and debate in improving the system. But those hearings were halted during the latest attempt to repeal Obamacare.
Allowing the Affordable Care Act to fail would be a reckless act born of ideology rather than thoughtful governance, endangering health care for some 20 million Americans. But, as congressional leaders demonstrated with the Children’s Health Insurance Program, they are not averse to being reckless.