Congress is holding CHIP and children hostage

Marian Wright Edelman | 10/19/2017, 7:29 p.m.
Dr. Lanre Falusi knows firsthand the anxiety families face when the future of their child’s health insurance is in jeopardy.
Marian Wright Edelman

Although the deadline has come and gone, most states still have some carryover funds to continue to operate their CHIP programs in the short term, leading many in Congress to erroneously believe the September 30th deadline was arbitrary when in fact it has immediate implications for real children and families. Some states have taken steps to put families on notice and are even prepared to modify or end their CHIP programs because of continuing uncertainty. Every day Congress delays action makes a difference. Dr. Falusi added: “We haven’t fallen off a cliff yet, but the uncertainty that there is a cliff looming ahead makes it harder to help parents think proactively about their child’s health. For me as an individual provider, it can affect the positivity -- the certainty of saying ‘See you back in six months for the two-year well-child visit,’ when I don’t know if they’ll still be insured and able to afford it, or if they’ll be trying to decide between whether they can afford transportation to the pediatrician’s office or transportation to work.”

The Minnesota State Health Department was the first to send a letter to Congress warning that despite predictions that said otherwise, its CHIP funding would run out September 30th and it would have to take “extraordinary measures” to continue coverage in October including the possibility that pregnant women could “be at risk of losing coverage all together.” As a result, earlier this week the Center for Medicaid and CHIP Services took measures to get Minnesota $3.6 million dollars to keep their children and pregnant women covered through October. Nine more states will run out of money before the end of the year and the uncertainty is causing other states to begin contingency planning and start the process of shutting down their programs because Congress has failed to act.

Utah officials have said they will end their CHIP program if Congress doesn’t provide new funding, and officials in a growing number of states have said they may need to follow suit. In her testimony to the Senate Finance Committee in early September, Linda Nablo, Chief Deputy Director of the Virginia Department of Medical Assistance Services and former Virginia CHIP director, emphasized that “there are serious consequences looming if [Congress] delays reauthorization – even for a few months.” While Virginia’s CHIP allotment isn’t estimated to be exhausted until March 2018, issues with health plan payment, adequate notice requirements, eligibility worker training, and system changes will require the state to start taking action in October in anticipation of exhausting their funding.

Parents are getting the message and now that fear is showing up in places like Dr. Falusi’s exam room. “The urgency is palpable from the family perspective . . . We know kids have colds, flu and asthma attacks that cluster in the winter. Right now is really the worst time for families to either fear or know for sure their child is about to lose their insurance coverage,” says Dr. Falusi. “Even if there’s a shortfall of a couple of months, in a couple of months a child’s asthma can go from controlled to the intensive care unit, which I’ve seen when kids go off of their medications…In the life of a child, even a couple of months can have some long-term lasting effects.”