As federal lawmakers continue to bicker over how to fund the Children's Health Insurance Program moving forward, states across the country are freezing enrollment and preparing for the worst.
CHIP funding lapsed Sept. 30 and has yet to be renewed by Congress, leaving states to patch together funding with monies redistributed by the CMS. But most of those dollars will run out by March at the latest, and states will have to finish processing all claims by the end of January and find a new plan to cover CHIP-enrolled children.
Connecticut and Colorado will shutter their programs Jan. 31 if funding doesn't come through and will shift its CHIP kids to Medicaid or a qualified health plan on the exchanges. Alabama will freeze CHIP enrollment starting Jan. 2 and would also need to close its program by Jan. 31, according to an official at the Alabama Children's Hospital.
In a late-breaking twist, Texas will not immediately freeze enrollment. The state, which was due to run out of its own funds in February, will get an additional $135 million in redistributed funds from the CMS.
Bruce Lesley of the Washington-based advocacy group First Focus, said moves like this by the agency further muddy the prospects for other states, as the CMS hasn't set out clear policies for how they allocate the redistributed money. Texas officials had sought $90 million in their original request.
Meanwhile, Lesley said, states like Minnesota and Arizona are out of money, and Oregon and California soon will be, according to the last projections by the congressional Medicaid and CHIP advisers.
The sudden end to CHIP programs would trigger a special enrollment period for kids who need to move to a qualified health plan. As of deadline, the CMS did not respond to a query about how the agency would manage the enrollment period for the federally facilitated marketplace.
CMS officials are planning to launch talks with children's health policy experts to figure out the best way to transition kids out of CHIP if they need to, said one Washington-based children's advocate who asked not to be identified.
Colorado, which runs its own state-based exchange, would run a 60-day special enrollment period set to start Jan. 31 when a child's CHIP coverage ends. The enrollment period would let kids start their new coverage on the first of the month following their application, says Luke Clarke, communications director at Connect for Health Colorado.
Congress has five working days left to keep CHIP running, but the GOP tax overhaul will take up most of the week before lawmakers will finalize the continuing budget resolution to keep the government open past Dec. 22.
House lawmakers led by Rep. Tom Emmer (R-Minn.) and Rep. Ryan Costello (R-Pa.) arranged a stopgap measure to allow states to apply any surplus from last year to fund their programs through year-end.
This has mitigated the immediate crisis for Minnesota, which had run out of its own funds in October, but children's healthcare advocates are skeptical of how much good this will do in the long run as Congress continues to delay.
"There are states that are out of money," Lesley says. "There's no kicking the can down the road.
He added: "It's a crisis, and they're pretending like it's not."
