WASHINGTON ― The House passed a bill Friday reauthorizing the lapsed Children’s Health Insurance Program. But instead of a bipartisan affair that Democrats and Republicans could pat themselves on the back for, the bill became a partisan fight over offsets that ultimately moves Congress further away from renewing CHIP.
The bill that passed Friday 242-174 ― with 227 Republicans and 15 Democrats voting yes, and 171 Democrats and 3 Republicans voting no ― almost certainly won’t become law. Instead, Congress will likely wait for an end-of-the-year spending bill to reauthorize the program, which covers roughly 9 million low-income children and pregnant women.
According to Democrats, the problem with the bill, which would extend CHIP for five years and reauthorize community health centers and other public health programs for two years, is that it would pay for children’s health insurance by taking money from a preventive care fund. The GOP bill would also use new Medicare means-testing to partially pay for CHIP. As Republicans repeatedly pointed out on the House floor Friday, Democrats were voting to protect seniors making $40,000 a month from paying about $135 more.
Debate on the floor was testy, with Democrats and Republicans going back and forth over who was to blame for letting CHIP lapse. Energy and Commerce Chairman Greg Walden (R-Ore.) blamed Democrats for their unwillingness to negotiate on offsets. The ranking Democrat on the Energy and Commerce Committee, Frank Pallone of New Jersey, blamed Republicans for spending nine months trying to repeal the Affordable Care Act.
“Now House Republicans are using the reauthorization of CHIP and community health centers as a way to once again sabotage the ACA,” Pallone said.
He said that by taking this route, House Republicans were guaranteeing CHIP wouldn’t be reauthorized until the end of the year, because Senate Democrats wouldn’t go along with this bill. And Pallone criticized Republicans for trying to undermine the ACA Prevention Fund, which helps pay for immunizations and research into preventing diseases like diabetes and Alzheimer’s.
Most states have had enough money left over to carry CHIP until the end of the year, some even well into next year, but children from some states face the possibility of losing their health insurance soon if Congress doesn’t act.
While Democrats and Republicans couldn’t agree on the offsets for the bill, Republicans also very nearly couldn’t agree among themselves.
Earlier in the week, GOP leadership tried to switch out the Medicare means-testing by just taking more from the Prevention Fund. That wasn’t the bill that Republicans reported out of committee, or the one GOP leaders agreed on, but Ways and Means Chairman Kevin Brady (R-Texas) apparently wanted to preserve the Medicare offset for tax reform or other legislation. GOP leadership decided they would change the legislation in the Rules Committee, and jam through the new bill on the House floor by modifying the bill’s language via an amendment in the nature of a substitute.
But when word got out to conservatives that leadership was going to alter the legislation in a rule, Freedom Caucus leaders objected. HFC Chairman Mark Meadows (R-N.C.) and Majority Leader Kevin McCarthy (R-Calif.) had a heated argument Tuesday night on the House floor over the switch, according to lawmakers who witnessed the exchange.
The usually talkative Meadows refused to say anything about the tiff ― “I really don’t want to talk about it” ― but members familiar with the disagreement said the moderate Tuesday Group, the conservative Republican Study Committee, and the ultra-conservative House Freedom Caucus had all agreed on an offset that took some money from the Prevention Fund and raised some money from Medicare means-testing.
“It was viewed when that changed at the last minute that ... we were taking a step backwards,” one Freedom Caucus member said of the group’s process concerns.
The Freedom Caucus met Tuesday night and quietly agreed they would take down the rule if leaders proceeded with their plan, citing their objections to Republicans “legislating on the rule.” (The rule is typically used to lay out guidelines for debate, though leaders do occasionally make legislative changes in the rule.)
By Wednesday afternoon, GOP leaders had caught wind of the plan and decided they would go back to the original offset deal, thus setting up the bill for its easy passage on Friday.
While the typical process for legislation is for it to pass one chamber and then go to the next, the Senate seems to have no interest in passing this CHIP reauthorization. As Democrats repeatedly said Friday, this issue will probably get vacuumed up at the end of the year in an omnibus spending deal.
In the meantime, Republicans will probably use the bill to ding Democrats for voting against a popular children’s health insurance program, Democrats will criticize Republicans for playing politics, and low-income children will be no closer to a guarantee of health insurance.