Michael Adame of Conroe, Texas, is preparing for Thanksgiving this year like he has for years past. He’s welcoming family from nearby. He expects some 10 to 12 people total to show up. And his wife is going to make tamales in addition to the traditional turkey. “I’m not crazy about tamales,” he teased.
But this year will be different in one fundamental and profound way. Adame will spend the holiday worried that his child might soon lose his health care coverage.
Adame’s 12-year-old stepson, Abraham, has Down Syndrome and is covered under the Children’s Health Insurance Program in Texas, where more than 400,000 children and pregnant women from low- and middle-income families receive these federal benefits. He goes to a children’s hospital in Houston where Abraham is monitored for a problem with his liver—specifically, to ensure that his enzyme level is where it should be.
“I thank God for what we have but if you take this away we won’t be able to monitor his liver level,” Adame told The Daily Beast. “He has regular dental and vision exams as he is growing and maturing and adjusting to a healthy lifestyle.”
Since its inception in 1997, CHIP has had strong bipartisan support and been a measurable success, covering nearly 9 million children nationwide. It helped lower the nation’s percentage of uninsured children from almost 14 percent when it started to about 4.5 percent in 2015. But this year, amid efforts to repeal and replace the Affordable Care Act, Congress allowed the deadline to reauthorize the program to come and go. Almost two whole months have passed since and there is growing concern that no action will come until the end of the year.
Families and state agencies have been forced to scramble amidst the uncertainty. Arizona, the District of Columbia, Minnesota, and North Carolina are expected to run out of CHIP funding next month according to the Medicaid and CHIP Payment and Access Commission (MACPAC). Another 27 states are anticipated to have their funds exhausted by March 2018 (PDF).
In Texas, where Abraham lives, the Texas Health and Human Services Commission has estimated that money will run dry by the end of February 2018. There are concerns that it may come even sooner, putting families like Adame’s in emotional turmoil just as the holiday season hits.
“He’ll go on the computer and watch the Minions and put on his goggles and his hard hat,” Adame said describing the things his son likes to do. “We try to accommodate the things that he enjoys.”
And yet, despite the urgency that is being felt by families dependent on CHIP, Congress appears to be struggling to come to a legislative solution.
On Nov. 3, the House passed a bill to reauthorize funding for the program. But only 15 Democrats voted in favor of the measure, criticizing it for draining funds from Obamacare to pay for the reauthorization. The Senate as a whole has yet to take a vote on its own bill, leading to charges from Democrats that Republicans are prioritizing tax reform over the health of millions of children.
“Senator [Ron] Wyden (D-OR) is fighting every day to get this urgently needed funding across the finish line before millions of our country’s children lose the health care coverage their families depend upon,” a spokesperson for Wyden’s office told The Daily Beast. “As the ranking Democrat on the Finance Committee and co-author of the bipartisan bill to extend CHIP funding for five years, he remains optimistic common sense and decency will prevail over partisan politics, and Republicans will put aside the tax charade long enough so essential coverage can continue.”
Families dependent on the program have been left waiting anxiously for signs of progress.
“I don’t understand at all,” Holly Keich, a mother of two in Camp Hill, Pennsylvania, told The Daily Beast. “It’s been 10 years that we’ve been on it with no issues. We send our paperwork in every year. It gets renewed.”
Keich’s children, a 10-year-old boy and a nearly 6-year-old girl, have been on CHIP since they were born, she said. And during that time, they’ve both been healthy. But without the program, her family’s finances would be complicated as they’d have to look for alternate options for health care coverage. Given Christmas and her and her husband’s upcoming birthday, she said, there might be “more coupon clipping” in the future.
Other families have turned to GoFundMe’s and used op-eds to raise awareness like in St. Louis where Myra Gregory said she is worried about her 10-year-old son Roland Williams, who relies on CHIP to help with his affliction from a rare form of lung cancer.
“There are so many other families out there that won’t even get treatment or be able to find out what’s wrong, or know that anything is wrong with their child,” Gregory told NBC News. “I am very appreciative of all the help that I’ve received. But not receiving this is detrimental and can mean my son’s life.”
In the interim, some states have taken matters into their own hands. In Wyden’s home state of Oregon for instance, the Oregon Health Authority announced this week that it would work to extend coverage for some 80,000 children and 1,700 pregnant women through the end of April. The move was done at the urging of Gov. Kate Brown, even though it could result in a shortfall in the state’s budget. Previously, the state had secured $51 million in leftover funds to last through December.
Idaho’s Department of Health and Welfare intends to look for a means to cover the state’s children through Medicaid rather than CHIP if reauthorization doesn’t happen soon, Chris Smith, public information officer with the department, told The Daily Beast. And there is a similar contingency plan in Arizona.
“We expect the current funding to sustain the KidsCare program into December,” Heidi Capriotti of the Arizona Health Care Cost Containment System told The Daily Beast. “If Congress takes no action to reauthorize funding soon, Gov. Ducey has a contingency plan to move money from a Medicaid program that covers a separate group of low-income children, into the KidsCare program. The children covered will not see any changes in their coverage or to the program.”
In Texas, advocates worry that funding will run out sooner than anticipated due to recovery effort needs following Hurricane Harvey. That could mean that families will receive a 30-day notice about the program ending right around Christmas.
“They’re kicking the can down the road but this is one thing they really can’t kick down the road,” Adame said.