Pennsylvania wrestles with uncertainty over children’s health insurance funding

A University of Delaware study has found a 6 percent decline in the number of Delaware primary care doctors providing direct patient care from 2013 to 2018. (Rick Bowmer/AP, file)

A University of Delaware study has found a 6 percent decline in the number of Delaware primary care doctors providing direct patient care from 2013 to 2018. (Rick Bowmer/AP, file)

For more than two decades, the Children’s Health Insurance Program, or CHIP, has provided health coverage to millions of kids nationwide. But lawmakers have yet to reauthorize it, and that’s putting states whose funding expires soon in a bind. In Pennsylvania, that could jeopardize health care for upwards of 150,000 kids come February.

“It’s really frustrating,” Teresa Miller, Pennsylvania’s acting Human Services Secretary, said. “We really thought we would see action taken before the end of September.”

CHIP’s budget runs at about $450 million in Pennsylvania, with 90 percent of that coming from the federal government. The state has one of the biggest programs in the country, with more than 176,241 kids enrolled, according to Miller.

State lawmakers have also been debating reauthorization of its share.

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CHIP, Miller says, has always been a popular program across political lines, but Congress has yet to reauthorize it amid stalemates over other health care and budget issues. While she’s hopeful lawmakers will reach an agreement, it’s “coming down to the wire.” Her agency is wrestling with whether or not to prepare to shut down the program and send out cancellation notices to families, if it’s not renewed in time.

“It’s been a tricky balance because on the one hand, we don’t want to scare these families,” said Miller. “This is a big issue for these families, having access to health care for their children. So we’ve tried not to needlessly scare them and go out with notices way in advance.”

Miller is holding off on those plans for now. CHIP funding in Pennsylvania dries up in February. She’d want to provide 30 days notice to families if their coverage were to end.

A report from Georgetown’s Center for Children and Families found that Pennsylvania is one of a handful of states coming up with some contingency plan before the end of the year. At least six states, according to the report, will run out of funding by the end of the year, or early January. Delaware’s Division of Medicaid and Medical Assistance projects its CHIP funding will last through January. About 8,300 children are currently enrolled, with a total cost of $30 million.

CHIP, meanwhile, has helped reduce the uninsured rate among kids in Pennsylvania to below four percent.

David Rubin, medical director of population health and director of PolicyLab at Children’s Hospital of Philadelphia,  has been researching CHIP trends nationwide. Similar to what he has been seeing firsthand with families in his own practice, he found that more and more parents who have private insurance options for dependents through their work are unable to afford it. CHIP, he says, has become a safety net for working families. Households earning up to $70,000 are eligible.

“I don’t think people have a firm handle of just how dramatic that increase in uninsured children will be if we don’t get this [reauthorization] done before the end of the year,” he said.

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