Today’s title comes courtesy of a 1997 Omaha World-Herald Editorial, when Nebraska was considering expanding Medicaid program through what’s known as CHIP, or the Children’s Health Insurance Program, to cover more low-income children. The federal government had recently passed legislation to give states the option of covering more kids through Medicaid and promised significant federal matching funds.
Fast forward to day. Last week, under similar circumstances, the Legislature considered covering more Nebraskans under the Medicaid program. The legislature debated LB 577 to cover 54,000 more low-income Nebraskans, including lower income working parents. The bill was stalled by a filibuster.
Back in the late 1990’s, all 50 states, including Nebraska, ultimately chose to cover more children through CHIP. In many ways, the current debate on Medicaid expansion for all adults mirrors the 1997 debate on CHIP. Lawmakers continue to wrestle with the questions – Is it affordable? Will the federal government uphold their end of the bargain? Will the program work?
We can’t know all of what the future will hold, but we do have over a decade of knowledge since we last collectively struggled with these questions. Here is what we know from the CHIP expansion:
1) The percent of uninsured children has been significantly reduced since 1997. It fell by almost half between 1997 and 2010.
2) The federal government has kept its promise. On average, the federal government pays 70% and state governments pay 30% of program costs. This is what was promised in the initial legislation.
3) Medicaid is an efficient program. The Medicaid program has lower administrative costs and lower per-person costs than private insurance.
The expansion of Medicaid through CHIP is widely considered a success, and we hope these lessons from the past can help inform the current debate.