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Thursday, December 21, 2017

Children's Health Insurance Program on Life Support

Posted by on Thu, Dec 21, 2017 at 9:39 AM

This post is excerpted from the INDY’s morning newsletter, Primer. To read this morning’s edition in full, click here. To get all the day’s local and national headlines and insights delivered straight to your inbox, sign up here.

Things are not looking good for the CHIP, the health insurance program that covers about nine million kids nationwide. If Congress doesn't renew funding for the program by tomorrow, nearly two million children could lose coverage in January alone, a new report by Georgetown's Health Policy Institute finds.

Congress failed to reauthorize the largely popular and uncontroversial program, which provides coverage to children from lower-income families who earn too much to qualify for Medicaid, in September, and now, the clock is ticking before the funds dry up. The report found that states are running out of money more quickly than expected—half will have no money for the program by the end of January if changes don't come soon—and warns that millions of children could lose insurance by the end of February. Already, the Alabama Department of Public Health put up a note on its website saying that it would freeze enrollment in the program on Jan. 1 and wouldn't subsequently renew any coverage.

Things have gotten so bad that desperate families even visited Capitol Hill this week to literally beg lawmakers to renew the program. How did it get this close? Renewing the program fell by the wayside as lawmakers rushed to approve the GOP tax bill this week, NBC explains.

  • "Already, state CHIP administrators say, parents are panicking and permanent damage has been done to the program, set up to take care of kids who don’t have health insurance through other programs."

  • "Earlier Wednesday, Democrats in Congress urged their GOP colleagues who control both the House and Senate to act by Friday. “This is the ultimate bad Christmas carol story,” Rep. Jackie Speier, D-Calif., said at a news conference where politicians held lumps of coal."

  • "Millions of kids stand to lose health insurance CHIP has bipartisan support, but Republicans have been focused on passing a tax reform bill — their first legislative victory for 2017."

  • From The New York Times: "CHIP’s fate, it appears, is now caught up in a messy fight over an end-of-the-year deal on spending that must be struck by Friday to avert a government shutdown."

  • "Congress has known since April 2015 that funds for the popular children’s insurance program — created and sustained for two decades with bipartisan support — would expire this year at the end of September. The Senate Finance Committee approved a five-year extension of funding for the program in early October, but did not specify how to pay for it — and Republicans insist that it must be paid for."

  • "While Congress squabbles, state officials are sounding the alarm. A survey by the Kaiser Family Foundation found that 16 states expect to exhaust their federal CHIP funds by the end of January, with 21 additional states saying they would run out by the end of March."

WHAT IT MEANS: Clearly this does not bode well for the millions of families across the country who rely on the program for health insurance. If Congress doesn't act soon, the truth is that many children will simply end up losing coverage. Count kids in North Carolina among them. We are one of the 21 states expected to run out of CHIP funds by the end of March; if that happens, the more than 200,000 North Carolina children who are currently enrolled in the program would be put at risk of losing their only source of health coverage. Naturally, parents who rely on the program are incredulous that the program's renewal took a back seat to a massive tax cut. They're also panicked. But North Carolina's Department of Health and Human Services says not to worry, Port City Daily reports.

  • "Some states, like Colorado, have already sent notices to families at risk of losing coverage for their children. Officials in Virginia are currently drafting a similar letter. North Carolina has not done either. Kelly Haight, a spokeswoman for the North Carolina Department of Health and Human Services, said North Carolina had sufficient funding to continue services, and that “North Carolina families will not experience any interruption of benefits at this time."

  • But even the possibility is concerning, especially considering how things have played out in the past.

  • A recent report by the Kaiser Family Foundation actually uses North Carolina a case study of the negative impacts of enrollment freezes: "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."

  • If that doesn't make you nervous, perhaps this N&O editorial—written by a North Carolina pediatrician, no less—will: "If Congress does not reauthorize CHIP funding and our state cannot find the money to continue CHIP, then providers will be in the uncomfortable predicament of terminating children born into Medicaid whose family incomes do not drop by the time they reach one year and six years of age, according to federal guidelines. If these CHIP children do not have health insurance, it is unlikely their families can afford to pay out-of-pocket for necessary health services."

WHAT'S NEXT: As with so many stressful and hugely consequential policy decisions, stakeholders now have no choice but lobby their representatives and then wait to see what happens. But with each day that passes,The Washington Post points out, "the pressure grows on families to find their own solutions." If the program's reauthorization doesn't pass, states, including North Carolina, will have to figure out what to do when the funding dries up. And in the meantime, anxious parents have no other choice but to wait.









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