NEW YORK/WASHINGTON--For Nancy Minoui of Portland, Oregon, and Crystal Lett of Dublin, Ohio, Congress' failure to fund the Children's Health Insurance Program is not some distant tale of political wrangling.
For Minoui, it's about how to provide care for her daughter, Marion Burgess, born last Valentine's Day with a hole in her heart. For Lett it's about providing care for her 6-year-old son, Noble, who was born with a complex genetic disorder.
They are among thousands of parents across the country scrambling to look after low-income children whose medical care is funded by a traditionally bipartisan programme, known as CHIP, that is now facing a shutdown after Congressional Republicans tied its fate to other legislative battles. U.S. states, which administer the programme but rely on federal funds, and healthcare providers are now preparing for the shutdown they had desperately hoped to avoid.
Virginia began on Tuesday sending notices to tens of thousands of families that the 20-year-old programme would close by Jan. 31 without new federal funding. Connecticut is due to mail similar notices this week. More than a dozen states, including New York and Utah, are poised to send warning notices to families by the end of this month.
Some hospitals and medical providers are encouraging patients to schedule additional doctor appointments and refill prescriptions before the deadline. Others, like the Texas Children's Hospital, are identifying families with the most seriously ill children, including cancer patients and transplant recipients, to help obtain alternate coverage.
CHIP provides health benefits to almost 9 million children whose families earn too much to be eligible for Medicaid but cannot afford private insurance, and has enjoyed bipartisan support since it was enacted in 1997. But this year, funding for the programme expired on Sept. 30. Congressional Republicans have tied its fate to other legislative battles, including attempts to repeal Obamacare and a newer effort to overhaul the U.S. tax system.
Lawmakers had hoped to pass a five-year CHIP funding extension before they adjourned for the year. But aides in the House of Representatives and the Senate say they may not get to it until early 2018.
In the meantime, states have been spending down whatever was left of their CHIP funds, and some have received temporary relief from a $3 billion reserve. Minnesota became the first state to run out of money altogether in November, and is keeping the programme afloat from its own budget, projecting a $178 million deficit if Congress does not act next year.
Oregon expects to run out of federal money before the end of 2017, while Colorado was the first to begin notifying families of a Jan. 31 cutoff in late November. A third of states expect to exhaust funds by the end of January, and an additional 21 expect to run out by the end of March, according to the Kaiser Family Foundation. More than 1.2 million children are expected to lose health benefits if funding is not restored in 2018.
"We are spending a ridiculous amount of time and energy trying to kick Congress in the seat of their pants to get this done," Oregon Governor Kate Brown, a Democrat, said in an interview.
Hospitals have convened emergency meetings to see how they can salvage care for seriously ill patients, and determine their own financial hit from covering more uninsured children, according to interviews with nearly a dozen hospital officials.
