By Sandhya Raman

The House passed a bill, 242-174, on Friday to renew funding for the Children's Health Insurance Program, community health centers and other public health programs. The legislation passed easily even though many Democrats opposed the measure due to disagreements over the offsets.

"Three times at the request of the Democrats, we delayed committee action," said Energy and Commerce Chairman Greg Walden, R-Ore. "These delays meant Congress went past the deadline of Sept. 30. We cannot wait any longer. Patients cannot wait any longer."

Democrats disagreed, saying CHIP should have been addressed earlier in the year.

"House Republicans chose to spend the first nine months of this year trying to repeal the Affordable Care Act," said Energy and Commerce ranking member Frank Pallone Jr., D-N.J.

Advocacy organizations and state officials have been clamoring for Congress to act to extend funding for CHIP, community health centers and a number of other safety net programs. Most still had some money to keep operations going after the Sept. 30 expiration date but officials are increasingly nervous about running out. In the case of CHIP, federal health officials have been funneling some leftover funds to the states that are in the most dire situations.

However, the bill still needs to pass the Senate, where it may face some pushback.

"If this bill is partisan, it will never become law. It will go to the Senate and sit there," said Pallone. He added, "The vote shouldn't be held today because this bill is going nowhere."

The Senate has its own version. It mirrors the House bill's five-year extension for CHIP, would retain the same eligibility requirements and would phase out a funding bump in previous laws. But the Senate bill has the support of both parties in part because it does not include offsets, the issue that sparked the fight in the House.

House Republicans defended their cuts.

"The offsets are not draconian," said Energy and Commerce Health Subcommittee Chairman Michael C. Burgess, R-Texas. "We have ourselves a bill today that will fund some of the nation's most important public health programs."

On Thursday, 22 Democratic senators wrote a letter to Majority Leader Mitch McConnell, R-Ky., and Minority Leader Charles E. Schumer, D-N.Y., voicing their opposition to funding CHIP through cuts to the Prevention and Public Health Fund, which provides money for vaccines, smoking cessation assistance and other programs intended to improve people's health.

The offsets in the House bill include a $6.35 billion cut to the prevention fund over 10 years, increased premiums for Medicare recipients making over $500,000 a year and limits to Medicaid benefits for lottery winners. In addition, the bill would reduce the grace period for health exchange plans from 90 days to either 30 days or whatever a state chooses to set. It also would change Medicaid third-party liability _ which would bill an individual's supplemental insurance before Medicaid if applicable.

Both the House and Senate bills maintain a 23-percentage point funding bump that was provided in earlier laws for the first two years, after which the boost eases to 11.5 percent and returns to traditional levels for the final two years. In addition, the bills would retain existing maintenance-of-effort requirements to prevent states from reducing eligibility through fiscal year 2019, and for children below 300 percent of the federal poverty line through fiscal year 2022.

The legislation also would extend funding for community health centers and other public health programs like the Special Diabetes Program and the National Health Service Corps for two years each. It would also delay funding cuts to disproportionate share hospitals for two years, and would increase funding up to about $1 billion for the U.S. Virgin Islands and Puerto's Rico's Medicaid program.

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