Budget Agreement Extends CHIP, Funding for Clinics, and Reduces Funds for Prevention

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Advocates for health and heath care see today’s budget agreement as mixed news for Californians.

Funding was extended for children’s health insurance, community health centers and home health care visits for new mothers as part of a federal budget deal signed this morning by President Trump.

But funding to the federal Prevention and Public Health Fund was reduced as part of the same agreement.

Health advocates were excited about the extension of the Children’s Health Insurance Program, or CHIP, to 10 years. Last month, Congress had approved only a six-year extension of the program.

CHIP, a federal-state partnership, covers 1.3 million low-income children and pregnant women in California. Here, the program is folded into Medi-Cal, with most enrollees receiving a Medi-Cal card.

“Now we do have more certainty about children’s health insurance, which is a good thing,” said Michael Odeh, director of health policy for Children Now.

According to a Congressional Budget Office analysis, the 10-year extension will decrease the deficit by $6 billion between 2018 and 2027. This is because coverage through other federal programs, such as Medicaid and subsidies provided by the Affordable Care Act, costs more than coverage provided through CHIP.

The budget deal also funds community health centers for two years and the Maternal, Infant, and Early Childhood Home Visiting Program for five years.

Federal funding for the programs ended on October 1 of last year, which is also when funding for CHIP expired.

“It shouldn’t have been a fight to begin with,” said Anthony Wright, executive director of Health Access California. “Those programs should never have been allowed to expire in the first place, but it’s good that that is no longer an overhanging concern over our health system and our budget. It’s good that those can no longer be used as hostages for other political purposes.”

There are about 1,300 community centers in California that serve about 6.6 million residents, more than half of who are Hispanic. In rural areas, sometimes the centers are the only provider.

California Health+Advocates, which represents the interest of community health centers, was disappointed with the two-year extension and had hoped for a five-year extension.

Carmela Castellano-Garcia, the chief executive officer for the group, said in a statement that the extension is dramatically short of what the health system needs.

“Funding CHIP funds health care coverage but without funding for community health centers, our children don’t have access to health care services that they need,” she said. “I implore Congress to agree on a long-term funding solution for health centers as soon as possible.”

The Maternal, Infant and Early Childhood Home Visiting Program offers visits to at-risk pregnant women and mothers with young children. In fiscal year 2016, 3,516 families in 24 of California’s 58 counties received home visits through the program.

Odeh said the program is critical to helping children get off to a good start. “If you see the amount of brain development that happens in early childhood, it is critical to make sure the caretakers are healthy and supported as well,” he said.

Of concern to many advocates is the $1.3 billion cut to the Public Health and Prevention Fund. Money from the fund has helped fight child obesity, promote immunizations and provide safer streets.

Cary Sanders, director of policy analysis for the California Pan-Ethnic Health Network, said it is upsetting that the cut came right after Congress approved billions in tax cuts for the rich and corporations.

She also expressed disappointment that the budget deal didn’t offer protections for the children of undocumented immigrants brought to the country as kids. “We are disappointed that (legislators) are continuing to pit communities against communities,” she said. “We see the need for health care for all Californians.”

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