An Article About CHIP

What the CHIP is Going On?

Angela Bracero
Written in December of 2017

When I was about twenty-five years old, I felt the need to travel south for just one year.  I found myself a continent away in the giant metropolis that is Buenos Aires, Argentina.  It was during our stay in the city, when my ex-husband tripped and fell down the spiral staircase that led to our seventh-floor apartment.  The fell resulted in a twisted ankle that I thought warranted a trip to the hospital.  We sat in the tiny living room of our apartment trying to decide what to do, when our Uruguayan roommate Fernando consulted a worn out address book, and wrote a phone number down for me.  “Call this number, they’ll send a doctor,” he said handing me the slip of paper. 

             “A doctor will come here?” I asked quizzically. 

             “Of course,” replied Fernando

Feeling a bit skeptical, we called the number, gave our address, and we waited.   Sure enough, about a half hour later, a young doctor arrived on a motorcycle, dressed in white scrubs and carrying a black leather medical bag.  He gently examined the injured ankle, wrapped it up, and prescribed ibuprofen for the pain.  We sighed with relief and I can’t tell you for sure how many Argentine pesos we paid him, but it equated to something like fifteen dollars.

I later marveled about how convenient and stress-free it was to be able to receive medical care from your own home.  The idea of a “house-call doctor” made me think of “Little House on the Prairie times.”  The idea seemed both brilliant but for some reason antiquated.  The closest thing we had back home to quick but efficient medical care was The Little Clinic in our neighborhood grocery store.

“Does the home-doctor charge about the same price for everyone?” I asked Fernando later that evening.

              “Depends on your insurance,” he replied, “a lot of times it’s free.”

              “And if you don’t have insurance?” I inquired again.

              “Then you pay, but like you saw, it wasn’t much.”

              “What about if you’re too poor to pay?”

                Fernando shrugged his shoulders and smiled, “then you simply don’t pay.”

             “I wonder why we can’t have that back home?” I replied.  Those words are still ringing in my ears seven years later.

I am not in my twenties anymore.  I am not a free-spirited globetrotter, with the privilege of being on my parent’s insurance plan.  I haven’t felt anything close to free-spiritedness since I leveled up in the adult world, became a full-time teacher, and a mother to a toddler.  Back in December 2015, I was faced with the task of finding affordable health insurance for a baby due April 2016.  To be perfectly honest, it was my first foray into the complicated and ugly world of health insurance.  Since resettling back in the US from my year of Latin American adventures, I settled into a teaching job at an incredible Denver non-profit that provides its employees with quality health care benefits.  They cover a large portion of the cost for each employee, and the care we’ve received has always been quality.  However, they don’t have the funds to cover health insurance for employee dependents.  When I discovered that adding a baby to my health plan would cost me an extra $300 a month, I understood why.  There are many employees in our non-profit that have children, especially in our learning center, covering all employee dependents at $300 each dependent a month, could cost around $136,000 a year.

   By January, I had started to get very nervous.  I had already looked into Medicaid, but salary wise, I did not meet the requirements.  I simply make too much.  My partner’s insurance plan had a similar price for adding a dependent.  It wasn’t until about a month later, while watching a commercial ad at a local movie theatre, did I first hear about the Children’s Health Plan Plus, better known as CHP+.  In retrospect it’s crazy that I had never heard of its existence since it’s been around since 1997, but everything in life happens in divine time.  I immediately looked into the program and discovered that it’s designed to meet the needs of working families who don’t financially qualify for Medicaid, but can’t afford the exorbitant cost of private health insurance.  Better known as “Us Middle Folk.”  To date, there are about 75,000 children and 800 pregnant mothers who use CHP+ in Colorado.  My own daughter is included.   I enrolled my baby in the program when she was three days old.  For the past 18 months, I have paid a yearly fee, and have utilized the health insurance plan when taking my child for routine check-ups and to the dentist.  For 18 months, I got to breathe a sigh of relief and relish the fact that my child had quality health care that was within my budget.  For 18 months, the anxiety and worry I carry around about getting my child’s needs met was put to rest. 

            Then, on November 2, 2017, I received an automated text from CHP+ informing me that my daughter’s benefits would be ending January 31, 2018, unless congress passes a law to renew federal funding.  The anxiety that was laid to rest just 18 months ago crawled back up into my stomach. My first reaction was panic, “What am I going to do? Should I be shopping around for another option? There are no other options! Do I wait?” My anxiety got the best of me and I chatted online with a CHP+ representative.  The outcome of our conversation ended in a simple phrase, “we just have to wait and see…”

            This response did not quell my anxiety, in a way the uncertainty of the situation has caused it to worsen. It’s now always in the back of my mind. When something involves my kiddo, I take it personally, and I know I’m not the only parent losing sleep over this issue.  There are parents of 75,000 children wondering what to do.  There are about 800 pregnant women waiting too, and it hit me one day, during my solemn, winter dive home, I decided that on behalf of these thousands of people, I was going to find out what was going on.

In order to understand the history of CHIP, I am going to take you back to the 90s when the Children’s Health Insurance Program, better known as CHIP first started.  CHIP was passed by congress in 1997.  President Clinton’s failed proposal for comprehensive health care reform in 1993 (yes it’s been almost 25 years and we still haven’t figured out healthcare) led to the creation of CHIP five years later.  The insurance program was brought forth by Senator Orin Hatch, Edward Kennedy, and Hilary Clinton.  It ended up being the largest addition and expansion of taxpayer funded healthcare since the start of Medicaid back in 1965.  This new program started a sort of partnership amongst both US states and the federal government.  Using funding both from the government, and the state, Colorado created its own branch from CHIP and called it the Children’s Health Plan Plus, CHP+.  Currently, Colorado spends about $128 million on its CHP+ program.  Yes, that number sounds huge, but it is also 1.4% of the state’s $9 billion dollar budget.  All in all, if you break it all down, for every $100 the state of Colorado spends on CHP+ the federal government spends $88.  We call this a federal match.  To date, over 75,000 children and 800 pregnant women rely on this insurance program.  The highest numbers are seen in rural areas of Colorado.  CHP+ differs from Medicaid, as families are still responsible for paying enrollment premiums and out-of-pocket costs for medical services.  Remember, this insurance program supports working families.  The State of Colorado has seen a large increase in the cost of living.  Jobs in the education field, especially early childhood are both essential and low paying.  Many other teachers at the non-profit I work for have children on this plan.  Due to the rise of the cost of living in Colorado, the income and eligibility requirements were adjusted in 2009, and as a result, Colorado has seen a historically low number of uninsured children.

Since the birth of CHIP, debate about its funding has been brought forth to the political dinner table every two years.  In 2009, the program was extended to include migrant children living in the United States legally.  In 2010, the Affordable Care Act of the President Obama era provided additional financial support. The program was then supported by the Medicare Access and CHIP Reauthorization Act aka MACRA, which increased the federal match to 88% and extended funding only through September 30, 2017.  Which brings us back to when I received the dark text message of November 2, 2017.

For the first time in 21 years Congress failed to fund a Health Program that serves nine-million children nationwide, a program that nearly eradicated un-insurance amongst American children.  We may have spent the last 21 years unable to come to a bipartisan agreement about the operation of health care in this country, but why is the health of this nation’s children not being made a priority? I can’t tell you for certain what is going on in congress because of the obvious, I’m a simple teacher in Denver. However, my investigation took me back to September 2017, almost four months ago. 

September was a hot month for Congress.  The main focus in September was the repealing of the Affordable Care Act created by President Obama.  The efforts were unsuccessful and it seems as though the expiration date for CHIP was not placed at the top of the political totem pole.  Congress who is made up of both Democrats and Republicans allowed the health plan to expire.  This means that Colorado stopped receiving the federal funding it needs to keep the program running and was forced to foot the bill.  It was forecasted that Colorado would have enough money to keep the program running until January. 

            I can’t say for sure how much money this country has, or how it should be spent.  I’m not a politician, but I can see that this country has a budget of about $597 billion dollars for the military and the $15 billion for CHIP, and it makes me wonder.  I think back to the fifteen or so bucks we spent on the house-doctor in Buenos Aires, and how Argentina has seen its own sometimes bloody waves of political unrest, but yet still manages to make education and healthcare accessible to its citizens.  It makes me wonder how one of the richest and most powerful nations in the world can’t quite seem to get it together.   I wonder if greed is at the root of this strife.  I consider that a simple disconnect between congress and the needs of the American people could be at fault.  What I do know is that change needs to happen and it needs to happen this year.

            As far as what the future for CHIP holds, I cannot say for certain.  There have been talks about expanding Medicaid to absorb the families who use the program.  Colorado is looking into financial options of how to keep the program running if federal support fails to come through.  Personally I think Colorado should look into using funds from recreational Marijuana, or even simply increasing the yearly enrollment fee that families pay, but I’m not sure if these are viable options, and will result in a call or letter to our state’s representatives.  My investigation left me here, in the unknown, which millions of parents can tell you is a very scary place to be.

            This is what I do know.  I know that I will continue to wake up every morning and go to work.  I will continue to support and advocate our non-profit that helps single-parent homeless families, and my little preschool students who come to me having experienced trauma that sometimes keeps me up at night.  That’s okay though, because I choose to do this wok everyday because I see the positive impact it has on my hometown, and that in itself is the fuel I need to keep going.  The teachers, and social workers, and all the other hard-working Americans in this beautiful state, this amazing country, will continue to hold up this world that lately seems to be turned upside down.         

            Last weekend I was sitting on the couch with my little girl and we were watching a goofy Christmas cartoon on Netflix.  In the cartoon, the villain of the story says to the heroine something like, “Don’t you know that there is no hope in this town.  No Hope!”  The heroine wisely smiles and retorts, “but you see, there are children, and if there are children, there is always hope.”  That simple cartoon made a statement that I have since been holding on to during the times I need it the most.  During the times when I watch congress unable to come to an agreement about the importance of the health of our nation’s children.  However, I do have hope, because this is a strong country, I think a lot of people still hold on to strong core values, and I do believe there are congressmen and senators who want to make the health of this nation’s children a priority.  Time will tell, change will happen, and I hope that together we will figure out a way to come together during this brand-new year, and as a nation I hope we can thrive.