USA Today, Thompson Debate Using CHIP Funding To Cover Uninsured Adults

States that use unspent CHIP funds to provide health coverage for adults without children may "drive up federal costs and deprive other states of the child health funds they need," according to a USA Today editorial (USA Today, 8/15). In a report released last week, the General Accounting Office examined waivers approved by HHS that allowed some states to use unspent CHIP funds to cover low-income adults who do not qualify for Medicaid. According to the GAO report, HHS' decision to approve the waivers "is not consistent" with the CHIP program's "statutory objective" to cover uninsured low-income children, and thus "is not authorized" (California Healthline, 8/8). Although the waiver approval is "well intentioned," the editorial says that HHS' action "robs the public" of the opportunity to have a national discussion on how to expand health insurance coverage, the editorial says. At the same time, the "backdoor attempts" to expand coverage for adults may spend funds that originally were intended for children's health coverage. By permitting the waivers, HHS is allowing a few states to "game the system at the expense of others," effectively "hid[ing] the broader problem" of the increasing number of uninsured. The editorial concludes that HHS "can best advance the cause of health care for the uninsured by challenging Congress and [the] administration to make the real issue -- medical coverage for all -- a priority again" (USA Today, 8/15).

In an accompanying opinion piece, HHS Secretary Tommy Thompson says the waivers are a "common sense" way to "us[e] the tools we already have at hand in innovative ways" to expand health insurance coverage for "needy, low-income individuals and families." Noting that Congress has not moved to expand coverage, Thompson says that the Bush administration and the states have opted "not to wait." Thompson also notes that the waivers reviewed by the GAO report were not approved "at the expense of children" and that "no child will go without coverage because funds went to an adult." While the administration will "make no apologies" for approving the waivers, Thompson says the administration would "welcome additional congressional authority" to expand coverage. Thompson concludes, "Bottom line: The Bush administration is acting to provide immediate health care assistance to people who need it -- children, individuals and families. Action is what's needed -- not criticism" (Thompson, USA Today, 8/15).