For now, Dr. Angela Martin is a lot more worried about the Children’s Health Insurance Program than her young patients are — or their parents.
But if Congress can’t find a way to fund CHIP — a 20-year-old program that provides health insurance to kids — some of her patients will lose their insurance in a matter of months.
“Most of them are hopeful, because when you’re faced with having nothing at all, you have to be hopeful,” Martin said. “They’re hoping something else will open up.”
Nearly two weeks have passed since Congress missed the Oct. 1 deadline to fund CHIP, a program that provides health insurance for an estimated 9 million kids across the country. In Alabama, more than 80,000 kids get their insurance through the state’s ALLKids program, which gets all of its money from CHIP. Nearly as many are on Medicaid rolls because CHIP foots the bill for their coverage.
More than 3,300 kids in Calhoun County had some form of CHIP insurance in August of this year, according to state statistics.
Without federal money, most state children’s insurance programs are running on the gas they have left in the tank. Alabama officials say their program has enough money to run into February or March.
The program predates Obamacare, and in the past it’s had strong bipartisan support — but this year’s CHIP bill seems simply to have fallen through the cracks as lawmakers fought over repeal-and-replace and other hotly debated bills.
A bill in Senate committee would fund the program for another five years, though it doesn’t say where the money would come from. A House bill, also in committee, would pay for CHIP by taking money from Medicare and Affordable Care Act programs. It’s unclear when either bill will move forward.
“Right now, the crystal balls are very cloudy,” said Danne Howard, executive vice president of the Alabama Hospital Association.
Howard said “the pressure has never been higher” on Congress to act, largely because every state uses CHIP money and some are set to run out by the end of this year. Still, she doesn’t expect Congress to act until it has to — probably around Dec. 15, when lawmakers leave for the holidays and end their 2017 session.
“If they pass something at all, it will be a win,” Howard said. “It doesn’t seem like they can come together right now to pass legislation on anything.”
Attempts to reach Rep. Mike Rogers, R-Saks, for comment on the CHIP bills weren’t successful Wednesday.
If Howard’s Dec. 15 prediction holds true, things could be touch-and-go in Alabama. State officials say that if the ALLKids program does get shut down, the process will have to start a few months before the money runs out completely, in part because of a need to look closely at clients and see who might be eligible for Medicaid.
ALLKids director Cathy Caldwell predicts that many of the program’s families will find another form of health insurance if the program closes, but at a substantially higher cost than the roughly $100 per year parents pay for ALLKids. She estimates that about 15,000 kids, in the end, would have no insurance at all.
Last month, Caldwell said that notices to those parents, about a possible shutdown of the program, could go out as early as mid-October. But state officials are reluctant to pull that trigger unless they’re sure Congress won’t act.
“We keep getting assurances that it will pass,” she said.
State lawmakers saw a CHIP crisis coming months ago, and they set aside millions of dollars as a cushion in case the program blew a hole in the state budget. Since then, the state has settled a suit over conditions in state prisons, and prison officials have proposed at least $10 million in new spending to hire more staff. Some lawmakers project at cost of at least $30 million to satisfy the needs of a settlement.
It’s unlikely the state will step in and keep ALLKids running if federal money doesn’t arrive, said state Sen. Trip Pittman, R-Montrose, chairman of the Senate’s General Fund budget committee.
Asked if ALLKids parents should be worried about the program’s future, Pittman said yes.
“Anybody who gets a subsidy from the federal government needs to be worried about all of them, because these subsidies are unsustainable,” he said.
Pittman said current levels of federal spending can’t be maintained. He compared federal deficit spending to the growth of brush in California, which is now facing a rash of fires.
“When it burns, it’s going to burn hot and it’s going to burn fast,” he said. “It’s going to be a wildfire.”