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“[I]f one more congressman tells me ‘no problem, they believe in CHIP and they’re going to fund it’ and still they don’t, I think I’m going to scream. Because promises aren’t paying the bills and keeping kids covered.”
Officials in Virginia tried to hold off on this move for as long as they could, but ultimately they decided it couldn’t wait a single day longer.
On Tuesday, the state’s Department of Medical Assistance Services began sending out letters to the 68,495 children and 1,114 pregnant women enrolled in FAMIS, Virginia’s Children’s Health Insurance Program, to notify them their coverage will end on Jan. 31 of next year if Congress fails to reauthorize the program’s funding, which expired at the end of September.
“Parents need to know,” Linda Nablo, the chief deputy director of the Virginia DMAS.
Nablo’s department isn’t getting many confused or fearful calls yet. But, that fact isn’t as reassuring as you might think. For the most part, she suspects families are relatively unaware that losing CHIP coverage is a possibility.
“I’d rather have the phone ringing,” Nablo said. “Maybe not ringing off the hook but I’d rather know that families are aware of this and are alert to it and are asking questions and deciding.”
After all, she said, what if you are planning for your child to have a major dental procedure in February?
“Wouldn’t you want to know the coverage is going to end on Jan. 31 so you could move that appointment forward?” Nablo asked. Or, “what if your child is in the hospital and is going to be there for a while? Wouldn’t you want to be talking to the doctor and the hospital about what is going to happen if CHIP coverage ends?”
Health care providers have already begun thinking about the ways in which a potential CHIP shutdown might affect them.
“We’re hearing from hospitals that are attempting to calculate what the loss of CHIP’s funding might mean for their own revenue,” said Nablo.
The same day Nablo spoke with Route Fifty, she was contacted by a governmental affairs representative of the Virginia Commonwealth University Health System in search of CHIP data to plug into their financial projections.
Nablo’s agency, and dozens of other offices that have a hand in CHIP, have been working in high gear for weeks to be sure they’ve thought of every move that needs to be made to avoid leaving parents and providers in the lurch. They’re writing Frequently Asked Questions pages, training personnel to staff call centers, and getting the word out to all the organizations that will be getting questions from beneficiaries.
The delay on reauthorization has also forced Virginia, and other states, to completely reprogram massive IT systems that manage CHIP eligibility and enrollment. According to those responsible for the enrollment computer system in Virginia, the revised programming has to be ready and in place by Jan. 6 in order to be effective Jan. 31—which, given the intervening holidays, is right around the corner.
And, what makes this work much more complicated is the fact that children are still continuing to enroll in the program. “You could approve someone for this program on January 15 and shut it down on Jan. 31,” Nablo said.
A conversation about whether or not to freeze enrollment was had, but according to Nablo, Gov. McAuliffe decided to keep the rolls open because he “firmly believes eventually Congress will reauthorize and fund this program.”
And, Nablo said that’s a belief that appears to be shared by the members of Congress themselves.
“I think the members of Congress would still all say, every one of them, that CHIP will get funded,” said Nablo. She assumes that they’d say “that it’s a popular program, that they know how many of their constituents are covered, and that it will get funded.”
But still they fail to act. For Nablo, it’s getting harder and harder to contain the anger and frustration over this completely unprecedented position state officials are being put in.
“CHIP has never before been in jeopardy.” Nablo said. “I have never come anywhere close to potentially ending health care coverage for 70,000 people on one day. That’s a totally unique proposition. And not one that we have experience, or want experience, in doing.”
“This shouldn’t be happening,” she added. “This should not be happening. And if one more congressman tells me ‘no problem, they believe in CHIP and they’re going to fund it’ and still they don’t, I think I’m going to scream. Because promises aren’t paying the bills and keeping kids covered.”
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Quinn Libson is a Staff Correspondent for Government Executive’s Route Fifty based in Washington, D.C.