66,000 children and 1,100 pregnant women could lose health insurance if Congress doesn’t act soon. They get their insurance through a federally funded program called CHIP, and Congress hasn’t agreed to keep paying the bills. Now Virginia is preparing to shut the program down, because there’s no more money.
Richard Bennett is a pediatrician at a community hospital. The patients he serves in the east end of Richmond could just as easily be in southwest Virginia.
“It’s kind of the working poor and those that are in the gaps,” Bennett said. “It’s a lot of children that are in the gaps.”
The Children’s Health Insurance Program, or CHIP, pays for kids whose parents make too much money to qualify for Medicaid but not enough to afford private health insurance. And soon, they could lose that coverage.
“They may go into the pharmacy and they realize that their child is starting to wheeze a little bit and they need to get their albuterol refilled,” Bennett said. “They do there and the pharmacist says ‘I’m sorry I can’t help you because you don’t have insurance.’ Then what do they do?
They go without, Bennett said. Their condition gets worse.
“The cost will be exponential if they’re not covered because now instead of having medicines that can control their asthma, their diabetes, those children that have cancer, now they’re going to end up in the Emergency Room.”
Linda Nablo is Chief Deputy Director of Virginia’s Medicaid program. She says Virginia has enough leftover funding to run CHIP through January. But after that, children and pregnant women will be dropped.
And because there’s no guarantee federal funding will come through and the state can’t afford to pick up the multimillion dollar tab, the agency has to prepare to shut the program down.
So Nablo’s staff is reviewing contracts with providers, drafting letters to send to families.
“There are things families have to do and we have to help them do and inform them about and you can’t do that a week before the funding runs out,” Nablo said. “You don’t just throw a switch and turn it off.”
And yet Nablo hopes all the work is for nothing.
“I hope it’s all a big waste of time. Yes. And government resources. But nobody wants to see these kids lose coverage,” she said.
CHIP has always had bipartisan support, but this year it’s gotten tangled up in the “repeal and replace” debate, falling victim to the larger healthcare conversation. The September 30th deadline for funding came and went, without congressional action.
“I started out, months ago, thinking no way we would be here,” Nablo said. “I would say sitting here today in late October, I’m maybe down to 85-percent thinking it’s not going to happen. And if we make it all the way to December and they still haven’t acted, I don’t know where my confidence level lies.”
Other states have it even worse. 11 states say they’ll run out funding by the end of the year. Governor Terry McAuliffe sent a letter to federal lawmakers last week, urging them to reauthorize funding now.
If lawmakers wait until December, Virginia's Department of Medical Services will have to send letters out to families. Things will get complicated from there, warns Margaret Nimmo Holland, executive director of Voices for Virginia’s Children’s.
“It’s very confusing to get a letter that your insurance might be going away and you don’t know and there are like 15 different steps you have to take to figure it out,” Nimmo Holland said. “Once you’ve lost these families on health insurance it’s going to be really difficult to get them back. It’s also going to be costly to do outreach and find them again. So why are we going to spend all that money to ramp the system down and then have to ramp it back up?"
Both the House and Senate have drafted funding bills and agreed on the policy, but they haven’t agreed on how to pay for it.