A federal program that provides health insurance for about 390,000 Texas children must be reauthorized by Congress by the end of the month.
Most of the children in the Children’s Health Insurance Program, also known as CHIP, are in working-class families. These are families who are too poor to buy insurance on their own, don't have an employer that offers insurance and are not poor enough to qualify for Medicaid.
“This is a lifeline," says Joyce Mauk, a pediatrician in Fort Worth and president of the Texas Pediatric Society. "And it is exactly those families that are working as hard as they can to get ahead, but they're never going to make enough that they can pay a $5,000 deductible.”
Mauk says CHIP has allowed doctors like her to serve a population of children who didn’t have access to health care until the creation of the program in 1999. CHIP is a comprehensive benefit program, too, providing immunizations, well care and specialty care, among other things.
Unlike under Medicaid, some families pay into the program, depending on their income.
Mauk says both children and the doctors who serve them are facing a serious problem if Congress doesn't reauthorized CHIP before the end of this month.
“Physicians that are in any government-funded program – we're providing care to kids because it's the right thing to do,” she says. “But even not particularly good reimbursement to physicians would go away [if] the program went away.”
Ken Janda, the CEO of Community Health Choice, which covers children enrolled in CHIP, says he’s been speaking with lawmakers about reauthorizing the program and that, overall, people on both sides see its value.
“CHIP is part of a series of programs that help lift people in poverty to self-sufficiency,” he says. “We think it’s really great and, obviously, kids need to be healthy so they can be in school, so that they can get a good education, so they can get a job and their kids aren’t eligible for CHIP.”
That’s partially why he’s not worried about support for getting CHIP reauthorized. Janda says he is worried, however, that this “must-pass” legislation might become a political tool.
“Then the question is what might get added onto this bill that would be less favorably perceived by people," he says, "but they have to vote for it because it includes the CHIP funding."
There are already a couple of political battles taking place in Congress. Despite a short-term budget fight, Republicans are making another last-ditch effort to repeal the Affordable Care Act.
If Congress fails to reauthorize CHIP, Texas won’t be affected until next year, but Janda says it will cause a problem with providers that need certainty in enrollment and funding decisions earlier than the state’s budget writers need it.