BURKE, VA - OCTOBER 31: Marbell Castillo holds her granddaughter, Maia Powell for a check-up appointment at Burke Pediatrics on Tuesday October 31, 2017 in Burke. Maia is insured through the Children's Health Insurance Program. (Photo by Matt McClain/The Washington Post via Getty Images)
Congressional gridlock showed no signs of giving Saturday night even as lawmakers traded accusations of holding the Children's Health Insurance Program hostage in exchange for a short-term spending deal.
On Saturday, Senate Minority Leader Charles Schumer (D-N.Y.) likened the GOP use of CHIP as the sweetener for the House-passed continuing budget resolution as pitting children against one another, arguing Republicans continue to hold the line against extending the legal status of undocumented immigrants who arrived as children.
But as the political posturing continues, state CHIP programs teeter on the verge of collapse. The Medicaid and CHIP Payment and Access Commission, which advises Congress, projected 27 states and the District of Columbia will exhaust funds by the end of March. Another 18 states will run out of money by June. Only Illinois would be able to sustain its CHIP program for the entire year should Congress fail to reauthorize the program.
The House's continuing resolution, which would have ketp the government running for another month, included a six-year reauthorization of CHIP.
While aides on both sides speculate the pressure of a shuttered government might push the two parties toward a deal, no one sees immediate resolution in the offing. Democrats show no signs of going along with the three-week budget continuing resolution floated by Senate Majority Leader Mitch McConnell (R-Ky.).
Instead, late Saturday afternoon, House Democrats countered with a four-day stopgap to offer breathing room for negotiations.
One House GOP aide dismissed the idea of a four-day patch on the grounds it isn't enough time for the parties to reach a deal when they're so far apart.
The gridlock dims any hope the states running short on CHIP funds had for an easy resolution. And the CMS isn't providing much guidance on how states should proceed or how it will allocate $2.85 billion appropriated in a Dec. 22 continuing resolution.
Cathy Caldwell, CHIP director for Alabama, said she still doesn't know how much money she has to budget with before the ephemeral funding deadline ends. Because it's a fee-for-service state, Alabama would have to shutter it's program a month before the money runs out so provider claims from the previous month can be paid up.
"The bottom line is that our plan right this minute is just to hold on," she said.
Before the Dec. 22 budget patch, Caldwell had triggered plans to freeze enrollment Jan. 1 and terminate the program Feb. 1, but these plans are on hold pending congressional action.
Virginia and Colorado say they can fund their programs through February. Connecticut, which actually froze enrollment between Christmas and New Year's, changed the projected end-date on its website from the end of February until the end of March.
Instability for these states is made worse by the fact the programs can't immediately close. Temporary shuttering is costly, and Virginia's health services director Linda Nablo said the state's budget division has spent "a ridiculous amount of time" just trying to keep up with the immediate financial outlook for the program.
"I had never envisioned that the states could keep limping along and that Congress would let them limp along even though by then there was lots of media coverage,and lots of blasting of Congress for not authorizing this very popular and productive program for kids," Nablo said. "It seems to be a symbol of dysfunction."