Congress funds CHIP, but other programs remain in limbo

By Elizabeth Hewitt, VTDigger.org

WASHINGTON — Dr. Dynasaur’s condition is stable. The short-term funding package Congress approved this week to end a three-day government shutdown also reauthorizes a program that provides health insurance to 9 million children across the country, including those in Vermont’s Dr. Dynasaur program.

The children’s health insurance program, or CHIP, lapsed at the end of September. As part of a short-term continuing resolution Congress passed Monday, the program is reauthorized for six years.

Vermont officials had estimated that if Congress did not extend the program, the state would have faced a $21.6 million hole in the Dr. Dynasaur budget next fiscal year, and a $1.9 million shortfall in the current year. The program, which offers health care to children and some pregnant women, is funded by Medicaid and CHIP.

Department of Vermont Health Access Commissioner Cory Gustafson confirmed Thursday that the resolution means that Vermont will not face a shortfall in CHIP.

“We are naturally pleased that reauthorization was achieved and that the state will not experience a lapse in this critical funding,” Gustafson said.

Gustafson said the department is “watching federal funding related to Medicaid closely.” He said he is not aware of other specific programs that are at risk.

Other players in Vermont health care, however, are still watching Congress, and still waiting for action on federal funding for programs that have not yet been renewed.

All three members of Vermont’s delegation voted against the resolution Monday, which funds the government through Feb. 8. They objected to Congress relying on short-term spending packages rather than establishing long-term budgets. They also said the resolution had failed to address a range of major issues.

Sen. Bernie Sanders, I-Vt., said Congress should have taken up CHIP long before January.

“It should have been voted on three or four months ago,” Sanders said Thursday. “It’s nothing more than holding children hostage.”

He has been a vocal advocate of a federal program that supports community health centers, which also lapsed last year. Congress passed short-term support for the program in December, which will keep the centers funded through March.

According to Sanders, a fourth of Vermonters get access to healthcare at the state’s 12 centers, which provide services ranging from primary health care to substance abuse treatment to dental care.

Sanders said the fact that the centers were not funded in the continuing resolution Monday “certainly” contributed to his decision to vote against it.

“It is an absolute outrage and a disgrace and I’m working as hard as I can to get them funded as quickly as possible,” Sanders said.

Sanders also said it’s time for Congress to bring forward a full budget package that adjusts spending levels for the new fiscal year.

“We are funding every agency of government in exactly the same way we did, we are ignoring major crises facing this country,” he said.

Sen. Patrick Leahy, D-Vt., said there were many initiatives he felt belonged in a spending resolution.

“There are about 40 things we wanted in there,” Leahy said Thursday.

He is urging lawmakers to craft a long-term budget package, which, at 117 days into the fiscal year, is overdue. “Let’s have a real appropriations package,” he said.

“I’m not going to let them peel off one thing at a time,” he said.

Rep. Peter Welch, D-Vt., also voted against the resolution. In a statement Monday, he explained that he voted “no” because the country “cannot continue to lurch from one continuing resolution to another.”

Tess Kuenning, who heads the Bi-State Primary Care Association, which represents community health centers in Vermont and New Hampshire, said she is optimistic Congress will pass long-term legislation to support the program by the end of March.

“We have full confidence that the health center funding will be approved,” Kuenning said.

The centers could lose a total of $14 million in federal funds annually if the program is not reauthorized, she said, jeopardizing access to health care for more than 172,000 Vermonters who rely on centers around the state for their primary health care and many other services.

The short-term “patch” Congress approved in December means that centers have not experienced any lapse in funding from the federal government.

“What they have is sort of this time frame of uncertainty,” she said.

Meanwhile, Congress also has not reauthorized a program that provides a 2.5 to 3 percent bump in Medicare payments to home health agencies in rural areas. The program helps cover the additional costs of operating in remote regions, such as more mileage.

According to Jill Olson of the VNAs of Vermont, the extenders have not been reauthorized. Agencies have been managing with the loss of that funding since the beginning of the year. She estimated in December that without the program, agencies in Vermont would lose about $1.3 million.