Q & A: Congress let the Children's Health Insurance Program expire. What now for Pa. and N.J. kids?

Jaxian James Santiago, center, has his blood pressure checked by Dr. Jasmine Marahar, a first year intern at Cooper Hospital, in Camden.

Last week, as Congress’ focus was on efforts to repeal the Affordable Care Act, funding was allowed to expire for the popular Children’s Health Insurance Program (CHIP), created 20 years ago with bipartisan support to help kids from low- and moderate-income families.

Tuesday, Republicans announced legislation to provide five more years of funding for the program, which serves 8.9 million low-income children. No one’s coverage has been cut off, but some states have laws that require them to reduce coverage if federal money starts to decrease, and officials say they need time to notify recipients of possible coverage changes.

Both parties favor continuing the federal-state program, but Democrats have opposed cuts in other health spending that Republicans have proposed to help pay for the extension.The measure would provide almost $120 billion for states over the coming five years. But it would discontinue extra federal money states have received under President Barack Obama’s health-care overhaul.

The federal government covers most of the program’s costs, varying by state from 65 percent to 85 percent of total spending.

The Kaiser Family Foundation, a nonpartisan research organization, has said it expects 10 states to run out of money late this year.  Here is a closer look at the local situation:

What does the missed deadline mean now for children in Pennsylvania and New Jersey who are insured through CHIP?

A New Jersey state human services agency spokeswoman said benefits for Garden State children should be covered until sometime this spring. Pennsylvania was one of 10 states national experts thought might run out of funds by the end of this year. However, according to a state human services spokeswoman, coverage for Pennsylvania’s children should be secure until February.

What kind of care might these children lose if CHIP isn’t renewed?

Benefits vary somewhat between states, but the program’s range of benefits includes medical and dental visits for routine well-child care, immunizations, prescriptions, vision care, emergency care, laboratory and X-ray services, and hospital care. Some children with disabilities may also quality for benefits through CHIP. Some services require co-pays, and some states charge families premiums. In general, CHIP families may not be poor enough to qualify for Medicaid, but cannot afford private insurance.

Can states cover these benefits if the federal government does not step in?

Not likely, according to an analysis by the Kaiser Family Foundation. Most states assumed Congress would reauthorize CHIP when they drafted their 2018 budgets. Much of Congress’ health-funding attention had been focused on the fate of the Affordable Care Act. CHIP was last reauthorized in 2015.

Can Congress still  reauthorize CHIP?

Yes, and that is being urged by many child-health advocates including the American Academy of Pediatrics, and members of Congress are working on possible reauthorization legislation. The program’s champions include some local elected leaders. One of them is Rep. Dwight Evans of Philadelphia. “I am disappointed to see funding for the CHIP program miss the deadline,” Evans said. “The CHIP program has proven to be vital to maintaining balanced nutrition, enhanced wellness, and healthy neighborhoods for years. Our neighborhoods are stronger when we invest in them and provide the quality, reliable health care they deserve and depend on for stability.”

In mid-September, New Jersey Democrat Bob Menendez, a senior member of the Senate Finance Committee, joined Chairman Orrin Hatch, (R., Utah), and Ron Wyden (D., Ore.) to introduce the Keeping Kids’ Insurance Dependable and Secure Act, which would extend CHIP funding for five years. A Menendez spokeswoman said the bill is being worked on this week and will hopefully come up for Senate action soon.

Information from the Associated Press was used in this report.