[Editor’s note: With the effort to repeal the Affordable Care Act now on hold for the time being, Congress is turning its attention to other matters that have the potential to have significant impacts on North Carolina. The following essays from N.C. Budget and Tax Center experts Luis Toledo and Alexandra Sirota examine two that rank high on the list — re-authorization of the Children’s Health Insurance Program and President Trump’s proposed tax cut plan.]
By Luis Toledo
Federal funding for the Children’s Health Insurance Program (CHIP), which covers about 9 million children in the U.S. , has now expired because Congressional leaders did not renew its funding by Sept. 30 as required by law. The CHIP program was enacted in 1997 and provides affordable, high-quality, and consistent health care coverage for children who do not qualify for Medicaid and whose families lack access to affordable employer-based or private insurance.
Congress’ failure to renew funding for the CHIP program means over 256,000 children across North Carolina are at risk  of losing their only source of health care coverage. Furthermore, this decision by Congress also spells budget trouble for our state in 2018, as our General Assembly assumed continued federal funding for CHIP in the most recent state budget and failed to take seriously proposed federal budget cuts.
North Carolina is now projected to exhaust all of its federal funds for CHIP  within the first three months of 2018. In other words, our state could be one of many states facing a funding shortfall in this area if Congress does not extend federal funding.
The Kaiser Family Foundation summarizes the negative impact to families  and provides a North Carolina case study from the past that shows the real world implications:
Reductions in CHIP coverage will result in coverage losses for children and negative effects on children’s health and family finances. If states close enrollment and/or discontinue coverage for children in separate CHIP programs, some children could shift to parents’ employer-sponsored plans or Marketplace plans, but others would become uninsured. Previously, some states closed enrollment in CHIP for limited periods in response to state budget pressures, and studies show that this led to coverage losses, left eligible individuals without access to coverage, and had negative effects on health and family finances.
In North Carolina, enrollment fell by nearly 30% from about 72,000 to 51,300 when it froze enrollment between January and October 2001. The number of children determined eligible for CHIP but placed on a waiting list grew to over 34,000. Most (60%) children added to the waiting list were previously enrolled in Medicaid and were unable to transition to CHIP.
Enrollment freezes negatively affected children’s health and family finances. In North Carolina, parents with children affected by the enrollment freeze said their children experienced periods of being uninsured and that almost all needed care during the time that they lacked coverage. Parents often had to delay care while their children were uninsured and reported difficulties obtaining prescription medications for their children. Parents also reported that obtaining care while their children were uninsured resulted in significant financial hardships, requiring them to cut back on necessities, borrow money from family or friends, and accrue debt for missed payments on bills.”
The fact that Congress failed to act in a timely manner for such an important program affecting millions of children is unfortunate considering that a recent poll had found three-fourths  (75 percent) of the general public saying it was important for Congress to work on reauthorizing funding for the State Children’s Health Insurance Program (CHIP).
The bottom line: It is critical that Congress renew federal funding for CHIP and stop political budget games that hurt vulnerable families and children across America and North Carolina.
Luis A. Toledo is a Public Policy Analyst for the Budget & Tax Center, a project of the North Carolina Justice Center.
By Alexandra Forter Sirota
Last week, with the release of the tax changes planned by President Trump and leaders of the US Congress, North Carolina taxpayers braced themselves for another layer of experimentation that is sure to fail our communities and our economy.
New data released today by the Institute on Taxation and Economic Policy  confirms that the tax changes will primarily benefit the country’s wealthiest taxpayers, fail to target the middle class and reduce the ability to fund core public services in all 50 states.
In North Carolina, 57.6 percent of the net tax cut goes to the top 1 percent of taxpayers in the state. While better than the national figure of 67.4 percent, it is a staggering figure signaling the failure to achieve the middle-class tax cut promised.
Here are three additional points that are important in reviewing the proposed changes at the federal level:
- Federal tax changes will make worse our already failed tax cut experiment in North Carolina. We have documented how the tax changes have meant fewer dollars for the classroom and for our communities. Cutting taxes for the wealthiest did not strengthen our state’s economy, and doing so at the national level could hurt the national expansion underway that has driven NC’s recovery to date.
- Federal tax changes will result in $1.6 trillion revenue loss over the next ten years nationally that will make it even more difficult to meet the needs of our growing state. North Carolina is spending at a historic low, even as our population grows, our infrastructure needs updating and our communities need help to thrive. Federal dollars have historically played an important role in meeting our priorities as a state . The tax changes proposed will likely lead to significant cuts to many of the programs that support the health and well-being of older North Carolinians, the building and maintenance of infrastructure and basic utilities, and the education of our children.
- Federal tax changes will push the costs to future generations as current proposals call for increasing the deficit by $1.5 trillion . Children will pay the price for fewer resources in their schools and fewer supports for their healthy development. And as adults they will pay in the form of higher debt for the nation that the federal changes would force.
North Carolina has already experimented with tax changes that primarily benefit the few at the cost of us all. That experiment has failed. Expecting a different outcome at the federal level would be ridiculous.
Alexandra Sirota is the Director of the N.C. Budget and Tax Center.