Politics & Government

What the state stands to lose if Congress doesn’t reauthorize children’s health program

Washington state leaders are fretting over the possibility Congress might not revive a program that provides health insurance to more than 60,000 low-income children in the state.

There is bipartisan support in Congress to reauthorize the recently expired Children’s Health Insurance Program that paid $242.5 million to Washington in 2017, but legislation to do so has been delayed over fights about how much should be spent on CHIP and where that money should come from.

Top officials are hoping Congress moves to bring back the program — and at current funding levels — before the state must decide whether to reduce coverage for low-income kids or spend its own money on those services.

Until that happens, the state is planning for a scenario where it might get no more CHIP money before the current funding runs out in November, while also trying not to cause unneeded changes to its health systems or scare parents who rely on the federal aid.

State Rep. Marcus Riccelli, a Democrat from Spokane who serves on the House’s Health Care and Wellness Committee, said the congressional lapse in reauthorizing CHIP could lead to “really tough conversations” about “potentially increasing premiums or reducing coverage” for some families currently insured through the program.

Gov. Jay Inslee last week sent a letter to Washington’s Congressional delegation saying the state would have to notify parents by Dec. 1 that they may lose coverage if CHIP is not resuscitated.

“We want to send out notifications in plenty of time, but we also don’t want to unnecessarily alarm people,” said Amy Blondin, a spokeswoman for the state’s Health Care Authority, which administers CHIP. “We had been hearing for months that there was strong bipartisan support for CHIP, but, until the action is taken, we have to be in contingency planning mode.”

In Washington state, CHIP money is broken down to aid different groups of children.

About $49 million of the 2017 cash will pay for health services for 32,000 children whose families are between 210 and 250 percent above the federal poverty level.

State law says those children must get health coverage, meaning the Legislature would have to either replace those lost federal dollars or change the law if CHIP money vanishes.

The state also chooses to use $23.9 million in CHIP money to subsidize health services for about 15,700 children in families that are slightly less poor — between 250 and 312 percent above the federal poverty line.

About $85 million in matching funds provided by CHIP also help pay for children enrolled in Medicaid. The state got another $84 million for other programs aimed at providing other aid to low-income children and families through CHIP.

Inslee, in his letter to Congress, said losing CHIP money would force the state to make “difficult budget decisions.”

The letter says the state won’t be able to continue its current funding structure for programs past Feb. 1, 2018 without new money from Congress. Blondin said the state picked Febraury because it takes time to change its current systems and notify parents.

But, she said, the state technically would run out of money from CHIP at the end of November, meaning lawmakers would have to find a way to keep the programs running between then and February.

The state might be able to get a bailout from the federal government. Minnesota got an emergency boost of $3.6 million in federal cash this week since it is low on money.

Money to keep the program running also might have to come from state coffers.

Riccelli blamed Republicans in Congress for spending too much time trying to repeal the Affordable Care Act to act quickly on CHIP. Riccelli said he’d push to make the state cover any lost money to avoid reductions in services but noted he is hopeful it won’t come to that.

Sen. Ann Rivers, a Republican from La Center who chairs the Senate’s Health Care Committee, could not be reached for comment Friday.

Key leaders in Congress seem determined to reauthorize CHIP. Sen. Orrin Hatch, a Utah Republican and chairman of the Senate Finance Committee said in a statement Wednesday that CHIP is a “critical, bipartisan program.”

When that will happen is unknown.

“Because it’s bipartisan, there’s promise” the program will be reauthorized, Riccelli said. “It just seems to me like: ‘Get it done.’ ”

Walker Orenstein: 360-786-1826, @walkerorenstein