States pick up cost as Congress delays reauthorizing kids health plan

The federal program that provides health insurance to nearly 9 million low income children — including 219,000 in Ohio — expired two months ago, and states are beginning to panic that they’ll have to cut services to families beginning early next year.

Nearly half of all states — including Ohio — will have run out of their 2017 federal allotment for the nearly $15 billion Children’s Health Insurance Program by the end of December, according to the Medicaid and CHIP Payment and Access Commission, a nonpartisan legislative agency that provides information and analyses on Medicaid and the federal Children’s Health Insurance Program.

While additional dollars are available — contingency funds and surpluses from prior year allotments — seven states and the District of Columbia will run out of those dollars by the end of January, according to the commission.

Officials in some states — such as Colorado and Virginia — are preparing to send out notices to families that their coverage is at risk.

In Ohio, the CHIP program is run through the state’s Medicaid program. That means that federal law requires them to keep the program operating even without federal dollars.

Still, it would have an impact. If Ohio runs out of CHIP funding, the program would continue to receive federal reimbursement, but at a far lower rate — 62.78 percent compared to 96.95 percent. A spokeswoman for the Ohio Department of Medicaid said the group has enough contingency funding from prior years to keep the program running through February.

Still, child advocates in the state are concerned.

“This year has been insane,” said Brandi Slaughter, CEO of Voices for Ohio Children, an organization that supports the CHIP program. “Uncertainty is the name of the game.”

She said the state has assured her that families will not lose coverage and has held off sending notices “because they think we will get refunded here in December.”

They haven’t, however, told her how they would plan to pay for the program if the federal dollars dry up.

Created in 1997, the Children’s Health Insurance Program gives states financial support to expand publicly funded coverage to uninsured children who are not eligible for Medicaid. CHIP works by giving states block grants that must be matched with state dollars.

That the health insurance program, which has traditionally had overwhelming bipartisan support, faced troubles this year is surprising to Joan Alker, executive director of the Center on Children and Families at Georgetown University. She said she worries about the families who will receive notification that Congress hasn’t acted. Those families, she said, might not sign up their children even if it is restored.

In states that run the program through the Medicaid program, a financial hit is inevitable. States “are walking such a fine line,” she said. “They don’t want to alarm families, but they can’t wait forever because they have to run a program…a lot of states are really on the edge right now.”

The state’s two senators remain supportive.

“I strongly support the Children’s Health Insurance Program,” said Sen. Rob Portman, R–Ohio. “And I would urge the Senate to pass our bipartisan proposal as quickly as possible.”

Sen. Sherrod Brown, D-Ohio, also considers it a no–brainer.

“This place is so dysfunctional…that all over the country now families are getting letters saying ‘health insurance is going to be cut off for your children,’” he said. “To let those letters go out – it’s just damn near criminal.”

He said the program has always been — and continues to be — bipartisan. “We’ve always agreed to it,” he said.

He blames GOP leadership for prioritizing the tax bill over reauthorizing the program. The House passed a bill in early November to extend the program for five years, doing so in part by raising Medicare rates for wealthier seniors. And the Senate Finance Committee also passed a bill extending the program last month. But the full Senate has yet to take up the measure.

“It doesn’t fit within their goals,” Brown said.

Brown’s irritation over the slowness of the rollout showed during an exchange he had last week with Sen. Orrin Hatch, the Utah Republican who chairs the Senate Finance Committee.

Brown, bashing the Republican tax bill as a handout for the rich, earned a sharp retort from Hatch, who said Brown was making “a nice political play” and said he came from modest means. He said that such comments kept the two parties from working together.

Brown then suggested they do work together — on CHIP — in order to demonstrate their care for the poor. “I’m not starting with CHIP,” Hatch fired back.

While the delay has caused states to fret, some Senate Republicans say they believe Congress will ultimately extend the program when it passes a government spending bill in mid-December.

Still, the delay has been maddening for advocates such as Slaughter, who marvels that something that both Republicans and Democrats support has become mired in inertia.

“This is something everyone wants to do,” she said. “Why is this so hard?”

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