Two months past its deadline, Congress has yet to fund the Children's Health Insurance Program, leaving several states scrambling for cash.
Lawmakers grappling with the failed repeal of the Affordable Care Act allowed authorization of the program to lapse on Sept. 30. Although CHIP has always had broad bipartisan support, the House and Senate cannot agree on how to continue federal funding. And the Trump administration has been mostly silent on the issue.
CHIP benefits 9 million children nationwide and 370,000 pregnant women a year. It helps lower- and middle-income families that otherwise earn too much to be eligible for Medicaid. Like Medicaid, CHIP is paid for with state and federal funds, but the federal government covers close to 90 percent of the cost.
To keep the program going, states with unspent federal CHIP money have seen their excess sent to a handful of states running low on funds. But that is a bureaucratic Band-Aid; some large states are warning families they may not be able to rely on CHIP for much longer.
All told, CMS has given out $1.2 billion in redistribution dollars since October. To keep the program going would cost the federal government $8.5 billion over five years, the Congressional Budget Office estimates.
Saturday marked the 25th anniversary of Pennsylvania approving the original CHIP program, which served as a model for the national law, established in 1997. Since then, CHIP has been left in the fiscal lurch only once before. In 2007, CHIP went several weeks without funding authorization from Congress.
Here's a quick look at what the shortfall may mean to daily life.
1. Are any kids hurting because Congress has failed to fund CHIP?
No. But states such as California will run out of money within weeks. That state alone accounts for nearly 15 percent of all children benefiting from CHIP. Without federal money, state programs could freeze enrollment or suspend operation.
2. What are states doing since Congress missed the deadline?