Nearly three months after a reauthorization deadline for the Children’s Health Insurance Program (CHIP) came and went, Congress voted on Thursday to provide piecemeal funding for the program before they left for the holidays.
But the legislation passed did little to resolve the burgeoning crisis. And some state officials say that they are still planning to proceed as if the health care program for poor children will be fully out of funds in the near future.
The bill that passed, which was tucked into a larger government funding measure, provided an additional $2.85 billion for CHIP as a means of propping up the program until the end of March 2018. Additionally, the bill extended a previous measure allowing the Centers for Medicare and Medicaid Services (CMS) to free up redistribution funds for states in dire need.
The measure prevented a child health care tragedy from unfolding over the holidays. The Georgetown University Health Policy Institute had published a report on Wednesday which said that absent any kind of immediate funding from Congress, some 1.9 million children were posed to lose coverage in January, with another 1 million at risk by the end of February.
But, in all, the legislation was a far cry from the five-year reauthorization that advocates and many lawmakers said Congress needs to pass. And even though states and advocates were happy to see a small-scale funding plan, there was immediate concern that the patchwork fix left administrators in an unstable position and families confused as to whether their coverage will continue.
David Dearborn, communications director at the Connecticut Department of Social Services told The Daily Beast that the state was still reviewing financial options. Officials have warned that the state’s program, known as Husky B, which covers some 17,000 kids and teenagers, will end on Jan. 31 unless Congress reauthorizes funding. And, as of Thursday afternoon, prior to the vote, the Department of Social Services had no immediate plans to change their new-enrollment cutoff date of December 23, just two days away.
“I work with the state officials trying to manage this program and for them this is chaotic,” Maureen Hensley-Quinn, Senior Program Director for the National Academy for State Health Policy told The Daily Beast.
In Colorado, things were only slightly more certain. Late last month, the Colorado Department of Health Care Policy and Financing had sent a notice to families informing them that the program could end by the end of January absent a funding fix from Congress. Now, officials are waiting to determine next steps both from Congress and an independent request from Gov. John Hickenlooper (D) for more funding from the state’s Joint Budget Committee. State officials don’t want to send out a letter to CHIP enrollees that they may lose coverage only have to then backtrack.
“You don’t want to be following up next week and saying “You’re fine, we don’t mean it. We want to be able to give people clear direction,” Luke Clarke, Director of Communications for Connect for Health Colorado told The Daily Beast on Thursday. “Anything that keeps the program going is better than nothing. But it needs to come fast because the families have to be notified.”
For other states, like Alabama, the CHIP crisis is far more immediate and the short-term aid passed by Congress could very well prove helpful in pushing some difficult steps, such as sending out disenrollment letters to families right after Christmas. But even then, Congress’ intervention was a mere blip on the road to larger potential ruin.
Alabama had planned on sending such notices on December 28 informing families that they would be freezing enrollment on January 1 and disenrolling children by February 1. State officials said they will likely now move back that timeline but they are pressed still to figure out next steps.
“I talked with somebody in Alabama and if this passes, they would delay their January 1 enrollment freeze,” Hensley-Quinn told The Daily Beast. But she acknowledged, “That’s sort of kicking the can down the road a bit.”
Cathy Caldwell, the director of the Bureau of Children’s Health Insurance at the Alabama Department of Public Health, did not immediately respond to a request for comment.
Virginia's Department of Medical Assistance Services (DMAS) sent a letter to families on Dec. 12 informing them that the state’s program could be shut down on Jan. 31. But with this new influx of money, they're hopeful they can make it through the month.
“The additional funding congress has provided will allow Virginia to keep children and pregnant women covered through January and maybe longer,” Nancy Malczewski, Public Information Officer for DMAS told The Daily Beast. “We will have to wait and hear from CMS how much of this funding will come to Virginia before we can determine how long we can continue to operate FAMIS. We hope to have that answer shortly after Christmas.”
Among the problems states face even in the wake of Congress’ short-term CHIP fix is that it costs money and requires resources to develop contingency plans. Relying on a five-year funding window allows officials to easily budget. Working with funding on a month-to-month basis is exceptionally hard. Additionally, most states attempt to inform enrollees of impending outcomes with at least 30 days notice. And sending those notices isn’t free. In Colorado, Clarke said the cost of informing enrollees could be about $484,000.
So while Congress stopped a major problem from becoming an abject crisis on Thursday, it did little to give states actual relief.
“They’re going to continue to put states in this terrible position,” Joan Alker, Executive Director of Georgetown University Center for Children and Families told The Daily Beast. “They’re not giving families the piece of mind they need going into the holidays that their child’s health coverage is secure. And that’s what they should be doing.”