Because Congress failed to act in time, multiple safety net funding programs will head over a fiscal cliff this weekend, including those that provide for children’s health care, rural hospitals, and Medicaid and uninsured patients.
But efforts in the House are expected to begin next week that congressional staffers say they hope will be approved quickly enough to prevent any long-term financial problems for those who depend on the programs.
The funding set to expire this weekend affects the Children’s Health Insurance Program, known as CHIP, which covers 176,000 children in Pennsylvania; a program that provides 70 percent of the federal funding for Federally Qualified Health Centers that care for more than 800,000 low-income Pennsylvanians; the National Health Service Corps; and the Maternal, Infant and Early Childhood Home Visiting program.
Recognizing that two safety nets — the Special Diabetes Program and the Teaching Health Center Graduate Medical Education Program — would run out of money this weekend, Congress this past week approved bills to extend funding for them as part of a disaster relief bill.
The programs generally have wide, bipartisan support. Those that have not yet been funded, including CHIP, are expected to be part of bills that will be introduced next week.
“There does seem to be agreement in both chambers” that CHIP should be extended, said Joan Benso, president and CEO of the advocacy group Pennsylvania Partnerships for Children. “But the most important question is, what happens to the 176,000 children covered by CHIP [in Pennsylvania] until they approve” continued funding?
Some states, like Minnesota, say they will run out of money for their CHIP program, and others, like Utah, are threatening to end their programs.
There wouldn't be an immediate impact on the CHIP program — funded jointly by the states and federal government —- in Pennsylvania, though state officials are still urging Congress to act.
CHIP provides health insurance for children whose families earn too much to qualify for Medicaid.
Pennsylvania’s program could run through February, according to a statement from the state Department of Human Services.
“We would notify families at least 30 days before the date the program terminates for lack of funding,” said Kait Gillis, a spokeswoman for the department.
The Home Visiting Coalition, advocates for the Maternal, Infant and Early Childhood Home Visiting program, called the anticipated lapse a disappointment, particularly in light of “decades of evidence that MIECHV-funded home visiting models improve the health, development and education of young children.”
Home visitor programs assist pregnant women and parents of young children by sending a nurse, social worker or other trained person into the home who can assist with issues such as prenatal care, breastfeeding and child development.
Earlier this year, citing the positive impacts of home visiting, Allegheny County — with financial support from local foundations — launched a campaign to expand awareness of the services available to new moms.
“We are very concerned about this potential funding loss,” said Ryan Scarpino, a spokesman for the Allegheny County Health Department. “MIECHV funding, which comes through the state, supports our Nurse Family Partnership Program. This is an extremely effective evidence-based home visiting program.
“The entire program is funded through this mechanism and supports 135 clients who are first-time mothers. If the dollars were to discontinue, the program would not continue without additional state and/or local funding. Our other home visiting programs, including our Title V programming and our Open Doors campaign, however, would continue, as those are funded through a different mechanism.”
But one additional safety net funding source, the federal Disproportionate Share Hospital program, which provides additional support to hospitals for high levels of Medicaid and uninsured and underinsured patients, does not appear to have nearly as widespread support.
The program faces a 20 percent cut in funding this weekend, and an effort to delay those cuts — which were part of the Affordable Care Act — does not seem as likely as the other programs. It does not appear the delay in cuts to the DSH program is part of the bill being considered in the House.
Still, a coalition of health care organizations and activists has been pushing mightily to try to get Congress to further delay the cuts.
“This is a very fluid situation,” said Jeff Bechtel, senior vice president for health economics and policy at the Hospital and Healthsystem Association of Pennsylvania. “Obviously, we don’t want to see [these cuts to DHS] happen. We’re still hopeful.”
Mr. Bechtel and others were heartened when a bipartisan group of more than 200 House members — including eight from the Pennsylvania delegation — signed a letter to Speaker Paul Ryan and Minority Leader Nancy Pelosi on Thursday that asked for action to provide further delay on the $2 billion in cuts to the program, which would grow to $8 billion in cuts by 2024.
Rep. Tim Murphy, R-Upper St. Clair, and Rep. Mike Doyle, D-Forest Hills, are among those who signed the letter.
“Congressman Murphy and others understand how critical it is to continue funding these critically important programs,” said Mr. Murphy’s spokeswoman, Carly Atchison.
Mr. Doyle said in an emailed statement: “I’d like to see a delay in any cuts to DSH payments, and I’d hope it would be included in any package that moves with CHIP or [community health center] legislation next week – but that’s a decision the House Republican leadership will make.”
Democratic Sen. Bob Casey supports delaying the DSH cuts, but Republican Sen. Pat Toomey’s office said he had not yet taken a position.
“Should the Senate consider the issue, Sen. Toomey will review the measure and will continue to work in the best interests of Pennsylvanians,” his office said.
Kate Giammarise: kgiammarise@post-gazette.com or 412-263-3909 or on Twitter @KateGiammarise. Sean D. Hamill: shamill@post-gazette.com or 412-263-2579 or Twitter: @SeanDHamill.
First Published: September 30, 2017, 10:30 a.m.
