Deane Waldman

Opinion contributor

Can you imagine a business staying open if 90% of its customers didn’t like what the business did? Congress is just such a business, with an abysmal job approval rating that barely clears single digits.

The foot-dragging by Congress to re-authorize CHIP, the Children's Health Insurance Program, is a perfect demonstration of how Washington politicians continue to lose the public’s confidence. They constantly play political games at our expense, this time with our children’s lives.

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What's behind the delay in CHIP funding? Republicans want to offset the cost by charging affluent Medicare beneficiaries higher premiums and using some money from the Affordable Care Act. Democrats object to both, and say wealthier Medicare recipients already pay more.

The upshot: Both sides have turned approval of a desperately needed, universally desired program into another party-line battle. As a result, Congress missed the Sept. 30 budget deadline and did not appropriate funds. Some state CHIP programs are painfully preparing to cut services.

Keep in mind that CHIP, one of the few fiscally reasonable and medically effective government programs, has both Democratic and Republican support. It would be easily approved if considered without add-ons.

The latest political ploy is Sen. Charles Grassley's proposal to include price controls for prescription drugs as part of CHIP funding. Washington’s level of political cynicism brings to mind Rahm Emmanuel’s famous 2008 remark, “You never want a serious crisis go to waste.” Both Republicans and Democrats treat real world problems, such as health insurance for children, like a game of chess. They act as though people were pawns, not people. As the polls show, Americans don’t like it.

There are very few federal programs that have strong bipartisan support, broad public admiration and hard evidence to prove their value. CHIP is one. It is a federally supported health insurance program for poor families that is administratively under Medicaid supervision but is also separate and different. States have greater flexibility in the construction of their CHIP programs than Medicaid allows.

Medicaid covers families below the Federal Poverty Level and in many states those slightly above it. CHIP covers children in families above the Medicaid financial limit, up to as high as 300% of the FPL.

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Medicaid prohibits any requirement for personal responsibility. By contrast, many CHIP programs require parents to have some skin in the game by sharing costs or paying premiums. The federal government kicks in more for CHIP than Medicaid for children — 70% for state CHIP spending compared with 57% for Medicaid. Interestingly, CHIP can cost less than Medicaid. In Texas, for example, Medicaid spends $237 per child per month while CHIP costs $156.

One might think Congress would happily and quickly reauthorize CHIP funding. After all, it is cheaper and enjoys bipartisan support. Not so. Both Republicans and Democrats are holding CHIP funding hostage. They want to tie reauthorization to other, more problematic political goals.

We the People, or in this case We the Parents, demand that Congress immediately, and without adding contentious elements, re-authorize CHIP. I don't know if Congress can send its job approval rating into negative numbers, but does it really want to take that risk?

Dr. Deane Waldman, MD MBA, is director of the Center for Health Care Policy at the nonprofit Texas Public Policy Foundation, professor emeritus of pediatrics, pathology and decision science.