NASHVILLE — Absent action soon by Congress, funding for a federal program that provides health insurance coverage to 74,000 Tennessee children and pregnant mothers could run dry this May.
Funding for the Children's Health Insurance Program ended Sept. 30. But a planned re-authorization of the CHIP program has yet to make its way fully through Congress, with federal lawmakers in large part consumed by tax cuts, an earlier unsuccessful effort to repeal the Affordable Care Act and other factors.
That has state officials, including Tennessee Gov. Bill Haslam, fretting along with advocates and others.
The program is operated in Tennessee as CoverKids. According to the state's TennCare Bureau, 73,998 children, teens and expectant mothers received coverage through the program as of Oct. 31. The program provides subsidized health coverage for families who don't qualify for the Medicaid program for the poor yet don't earn enough money to buy coverage on their own.
With some 9 million children, teens and pregnant women served nationwide through CHIP programs, officials in some states are already serving notice to those covered that their federal funding soon will be exhausted.
Absent federal action, remaining funding in Tennessee's CoverKids program would run out in the second quarter of 2018. Sarah Tanksley, a spokewoman for the TennCare Bureau, said officials estimate that would be sometime in May. Warning notices likely would go out in March, she said.
Haslam and his counterparts are urging Congress to come to a funding resolution quickly.
"I am concerned," the Republican told reporters Monday. "People will have to realize that if that doesn't get re-authorized, we'll be providing less services."
Federal dollars provided an estimated 99 percent of CoverKids' $174.9 million total cost during the state's 2017 fiscal year, according to officials. Of that amount, Tennessee government provided $6.84 million.
In Tennessee, the program is intended to benefit lower- and middle-class families who aren't poor enough to qualify for other federal assistance. For example, a working adult may have health insurance from their employer but may not be able to afford coverage for other family members.
Premiums are paid by the state, but Tennessee CHIP enrollees can be charged modest co-payments ranging from $1.50 to $100 for some health care services such as non-preventive doctor visits, hospital visits and prescription drugs, according to a report by the Georgetown University Health Policy Institute's Center for Children and Families.
Because the state pays BlueCross BlueShield of Tennessee in advance to provide CoverKids insurance, said Michele Johnson, executive director of the Tennessee Justice Center, there would be "at least a 90-day lead time" on providing notice to enrollees on when the money runs out.
But the notice itself is "going to create enormous chaos within families and within the TennCare Bureau," Johnson warned.
A number of beneficiaries would likely qualify for TennCare, the state's Medicaid program, but not all would. Johnson said her concerns include the Haslam administration still working on a new computerized Medicaid eligibility system and fewer state workers to sort out issues for CHIP enrollees.
But TennCare's Tanksley said "there is a path for individuals seeking to apply for TennCare coverage and that will be the same going forward." Those seeking to apply for TennCare can do so through healthcare.gov, she said. Meanwhile, she added, Tennessee Department of Human Services offices across the state "do in fact have trained staff to assist individuals with the application process."
Those choosing not to apply online can submit their applications over the phone or through mailing a paper application, she added.
According to the Georgetown University Health Policy Institute's Center for Children and Families, 96 percent of Tennessee children had some type of health insurance coverage in 2016, either through CoverKids, TennCare or private coverage. In 2016, nearly 900,000 children and teens had some type of public coverage.
CoverKids provides coverage to Tennessee residents under 19 years of age who aren't eligible for TennCare, are U.S. citizens or legally reside here and whose families' income is at or below 250 percent percent of the federal poverty level.
For a single person, that's an income of $30,150 per year. For a family of four, it's $61,500 annually.
For pregnant women, they must be Tennessee residents, not eligible or enrolled in TennCare and have a family income of 250 percent or less of the federal poverty level.
Congress has been working on reauthorizing the program.
In early November, U.S. House Republicans passed a five-year re-authorization for CHIPs, but the legislation has been sharply criticized by Democrats, advocates and others for cuts to public health spending elsewhere.
U.S. Sen. Lamar Alexander, a Tennessee Republican who is chairman of the Senate Health, Education, Labor and Pensions Committee, gave qualified praise of the House bill when it passed but broadly hinted in a news release the Senate had its own ideas.
The House measure, meanwhile, appears to have been a non-starter in the upper chamber. Senate Finance Committee members have now passed their own reauthorization bill but haven't said how it would be funded.
On Sunday, Senate Majority Leader Mitch McConnell, R-Ky., said on ABC's "This Week" that GOP senators plan to include a CHIP provision this month in a second year-end continuing resolution measure this month.
"We need to make sure the Children's Health Insurance Program, which is expiring, gets to panel before the end of the year," McConnell said.
The Hill, meanwhile, reported Monday that a provision in the funding bill is intended to make it easier for states to receive leftover money from the federal Centers for Medicaid and Medicaid Services.
There are restrictions on the amount of unused funds a state can get, but the bill would lift those through Dec. 31, The Hill reported.
Contact Andy Sher at firstname.lastname@example.org or 615-255-0550. Follow on Twitter @AndySher1.