Purohit Pediatrics

Dr. Naresh Purohit checks the heart of 5-month-old Lloyd Mitchell at Purohit's office on Quintard Avenue in Anniston. Lloyd is being held by his mom, Lucie Mitchell. (Stephen Gross / The Anniston Star)

Health insurance coverage could end for more than 80,000 Alabama children Feb. 1 if Congress doesn’t act soon.

Cathy Caldwell, director of the state ALL Kids program, funded by the federal Children’s Health Insurance Program, said if Congress doesn’t renew spending for CHIP, her office would send notices to parents Dec. 26 about the impending end of their children’s health care coverage.

Most of the ALL Kids recipients would be ineligible for other federal social insurance programs and find private insurance too costly — meaning more untreated, sicker kids and higher, unfunded health care costs for hospitals, some health care experts say.

Without congressional action, ALL Kids will end coverage for all of its recipients Feb. 1, Caldwell said. Also, enrollment in the program would freeze Jan. 1, she said.

“Everything we’re hearing right now is Congress has every intention to continue funding CHIP,” Caldwell said. “But right now we’re planning to send notices to families Dec. 26 … it’ll explain that their children’s coverage is ending Feb. 1 if Congress hasn’t done anything by then.”

Congress missed the Sept. 30 deadline to fund CHIP, which provides health insurance for around 9 million children in the U.S. In Alabama, ALL Kids provides health insurance for 80,000 children based on their poverty level, with money provided through CHIP.

More than 3,300 kids in Calhoun County had some form of CHIP insurance in August of this year, according to state statistics.

House leadership recently announced a short-term CHIP funding plan to help states, however, nothing has been approved.

Caldwell said if the funding ends, ALL Kids would help families find coverage elsewhere, but noted that their options would be limited.

“Most of our current enrollees are not eligible for Medicaid,” Caldwell said of the federal social insurance program that also covers poor children. “We will try to redetermine their eligibility for Medicaid if anything has changed and then transition them.”

Caldwell said her office would also help parents look into the insurance marketplace provided by the federal Affordable Care Act, widely known as Obamacare. The marketplace offers tax subsidies to help make health insurance more affordable to those who qualify.

“When everyone is disenrolled, we will send their data to the marketplace, then the marketplace will determine if they’re eligible for tax credits,” Caldwell said. “Then the parents will have to make a decision to purchase the insurance.”

Dr. Naresh Purohit of Purohit Pediatric Clinic in Anniston said many of his patients use ALL Kids and that they would have limited access to care without it. Purohit said his patients’ parents can’t afford private insurance, but still make too much money to be eligible for Medicaid.

Purohit said that without ALL Kids, many parents would likely only take their children to a doctor for vaccinations or stop taking them all together.

“They’ll treat them at home and many kids will get sicker than usual,” Purohit said.

Eventually, some children would get so sick that parents would need to take them to hospital emergency rooms, Purohit said.

“Admission rates at hospitals will go up and costs will rise,” he said.

Rosemary Blackmon, chief operating officer for the Alabama Hospital Association, said hospital leaders in the state were very concerned about the potential loss of CHIP coverage and are urging Congress to solve the problem.

“Children who do not have coverage often don’t have access to the preventive services needed and sometimes end up in hospital emergency rooms with a worsened condition and no means to pay for the cost of treatment,” Blackmon said. “Alabama was one of the first states to implement the Children’s Health Insurance Program … we really need to keep this option available to Alabama’s families.” 

Staff writer Patrick McCreless: 256-235-3561. On Twitter @PMcCreless_Star.