Kids enrolled in Kentucky’s Children’s Health Insurance program, known as CHIP, could lose their coverage in March if Congress doesn’t pass a bill to fund the program. According to the Kaiser Family Foundation, 92,728 Kentucky kids had health insurance through CHIP in 2016.
Kentucky’s version of the program is for uninsured children living with caregivers who make under 200 percent of the poverty limit — that’s $42,400 for a family of four. CHIP provides benefits for kids including dental care, hospital visits and speech therapy.
Congress allocates money for the federal-state program every five years. But on Sept. 30, lawmakers allowed CHIP to expire. Republicans proposed measures to fund CHIP that included cutting the public health fund created by the Affordable Care Act, raising premiums for some Medicare enrollees, and cutting the amount of money the federal government gives to states to pay for CHIP — provisions largely unpopular with Democrats. The measures stalled.
In the meantime, states are running out of money for CHIP. Each state runs its own program and determines income eligibility. This week, Virginia sent letters to recipients warning them that they could lose CHIP benefits in February. Alabama will send out similar letters later this month.
Doug Hogan, spokesman for the Kentucky Cabinet for Health and Family Services, said Kentucky has applied for redistribution funds — a pool of money that comes from states that have not exhausted their own CHIP funding. But Hogan would not answer questions about how far any redistribution funds would go in Kentucky or when Kentucky will have to send out letters informing people coverage may be terminated.
‘The perfect healthy individual’
Meera Patel’s parents immigrated to the United States from India and opened a small hotel in Western Kentucky a few years after she was born. Her parents made too much to qualify for Medicaid, but too little to afford health insurance on their own.
“They didn’t want us to run around and do sports because we could break something and that wouldn’t be good for going to the hospital, and the expense,” Patel said.
That changed when her parents found out about CHIP. With the benefits, Patel was able to get cavities filled, get eyeglasses, and her brother was able to get an inhaler for his asthma. Now 25 and attending Bellarmine University, she said she’s concerned about the future of the program and for kids today who need it.
“With children, they don’t smoke, they don’t drink — it’s the perfect healthy individual,” she said. “So it’s a shame. At least kids should deserve health insurance, especially if their parents can’t afford it.”
CHIP was created in 1997 to help reduce the number of uninsured kids in the U.S. At the time, there were around 10 million uninsured children across the country. By 2015, that figure had dropped to 3.3 million uninsured kids, according to the Medicaid and CHIP Payment and Access Commission.
The problem with CHIP comes down to how to pay for it. In 2015, the program cost $14 billion. While states pay for a portion of the costs, the federal government picks up a much bigger share. In 2015, the federal government paid for 71 percent of the program; cumulatively, states paid 29 percent of the cost, according to the Medicaid and CHIP Payment and Access Commission.
Terry Brooks, executive director of Kentucky Youth Advocates, said reauthorizing CHIP funding has become political and that’s bad news for kids.
“Using it as a bargaining lever in broader debates is simply not acceptable and it puts the health of Kentucky kids on the line,” Brooks said. “Our state budget cannot be expected to simply cover the cost during parliamentary shenanigans in D.C. and our families cannot afford to move into 2018 with a storm of uncertainty around their children’s access to health care.”
Health workers in Kentucky are also concerned. Marsha Collins works at the Cumberland Family Medical Center in southern Kentucky, and said CHIP helps many school-aged patients to be able to go to the doctor. She is also a single mom of two sons, now in their 20s. Though Collins has always worked a full-time job, her income qualified her sons for CHIP coverage. She said the program made gave her one less thing to worry about.
“You worry about everything,” she said. “‘How am I going to feed them? How am I going to pay my rent?’ When you’re on such a limited income, there’s so many pieces to the puzzle that whenever you’ve got the Kentucky Children’s Health Insurance, you don’t have to worry about that part of it.”
Congressional members are pushing to fund CHIP this month as part of a short-term spending bill, though there’s no vote scheduled. The next opportunity would come in January as part of a larger spending bill.
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