States from Oregon to Massachusetts are scrambling to help millions of poor families whose children could lose coverage if Congress fails to reinstate a health insurance program that was approved two decades ago with bipartisan support.
The Children's Health Insurance Program is on the brink of running out of money, and Congress has dragged its feet in passing a reauthorization bill since the program ended on Sept. 30. If lawmakers don't pass a budget by Dec. 8, the federal government could shut down with the CHIP bill still in limbo.
That's bad news for people like Yvette Lucas, a nurse and mother of two in Virginia, who worries that her 5-year-old son could lose coverage. He was born as a micro-premature baby, weighing in at under 2 pounds (900 grams), and was later diagnosed with cerebral palsy. His older brother needs weekly speech therapy, which is paid for by CHIP.
"I don't know what I would do if I didn't have it, what other families would do," Lucas said. "These are working parents who are trying to make ends meet."
Faced with many cases like Lucas's, state governments and social-service agencies are lobbying lawmakers and drawing up contingency plans. Colorado has sent letters to CHIP recipients, warning that they could lose coverage. Idaho, Arizona and Oregon have found alternative revenue sources to fund their CHIP programs if and when money runs out.
Teresa Miller, acting secretary for Pennsylvania's Human Services Department, said she believes Congress will pass a bill in time.
"I hope I'm right," she said. "But if I'm not, we will be prepared to shut the program down."
Congressional lawmakers support the program's merits but have yet to agree on how to pay for it. A spokesman for Senate Majority Leader Mitch McConnell said in an email that "bipartisan work continues."
While the failure to reauthorize CHIP would be massively disruptive, not all 9 million children in the program would lose coverage. When the act was passed in 1997, states could either make CHIP part of their Medicaid program, or they could set up a separate system just for CHIP. Most states did a combination of both.
Under the Affordable Care Act, states are required to maintain Medicaid CHIP programs until 2019, but if the bill isn't reauthorized, they would receive a lower federal matching rate. Meanwhile, separate CHIP programs, which cover about 3.7 million children, would be terminated, unless states figure out a new source of funding. The Kaiser Family Foundation, a nonprofit, estimates that a majority of states will run out of CHIP money by March.
Buying Time
When states started running out of money for the program in October, they began reaching into the federal government's $3 billion pool of reserve funds. But that's still $10 billion short of what they need for 2018, according to the Centers for Medicare and Medicaid Services. So far, 15 states, plus the District of Columbia and the U.S. territories, have received a total of $1.2 billion from the pool to keep their programs going, even if only for an extra month or two.
