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Health care fallout: Fate of 8M low-income children in limbo

TC Bell sits with his two daughters, Dagny, 8 and Emma, 4, before they get dressed for school at their home in Denver on Tuesday, Nov. 28, 2017. Bell's daughters are recipients of the Children's Health Insurance Program or CHIP, which is a program that provides low-cost coverage to families who earn too much to qualify for Medicaid. Arizona, California, Colorado, Minnesota, Ohio, Oregon and the District of Columbia are among the first expected to exhaust their CHIP allotments. (AP Photo/Tatiana Flowers)

At a time when some states say they will soon run out of funding for a popular children’s insurance program, Missouri says its funding is expected to last until June.

A director within the state agency that oversees the state’s Medicaid program told health advocates and experts in a recent meeting that she expected the funding to last for several more months, according to two individuals who attended the Dec. 12 meeting.

However, a separate report by Georgetown University’s Center for Children and Families said Missouri and 20 other states were at risk of a funding shortfall in February.

That means nearly 1.7 million American children are at risk of losing coverage in February, according to the report, including about 90,000 in Missouri who rely on CHIP, the Children’s Health Insurance Program.

“Without CHIP, Missouri kids would lose access to necessary medical appointments, immunizations, health screenings, medically necessary therapies and other treatment that the program covers. In addition, pregnant women covered by Show Me Healthy babies will lose access to medically necessary prenatal care services,” said Joel Ferber, a lawyer with Legal Services of Eastern Missouri, a firm that represents low-income individuals.

When the Post-Dispatch asked about the potential funding issue, the department said, “CHIP ending is not an imminent issue for Missouri,” according to an email from Rebecca Woelfel, spokeswoman for the Department of Social Services, which oversees the state’s Medicaid program.

According to authors of the Georgetown report, one reason for the discrepancy may be because of a rule change in how to dispense funds from a pool of money that is used when states experience a shortfall in paying for the program.

Missouri may be relying on that funding, which may explain the discrepancy between the report and Missouri’s expectation of when funding will dry up.

Officials with the Department of Social Services, the agency that oversees the Medicaid and CHIP program, did not respond to questions about the discrepancy between its projections and the report.

“It has become increasingly difficult to predict how long funds will last for any particular state. This uncertainty and the ongoing inaction by Congress increases the likelihood that states will take action to prepare families for the worst,” the report said.

According to the state’s current timeline, it would need to start warning families about the potential end to the program in April through a formal letter, according to Tim McBride, a health economist with Washington University and chairman of a committee that oversees the Medicaid program.

Fear about the fate of CHIP started when Congress failed to reauthorize funding for the popular program that covers 9 million low-income children throughout the country and has bipartisan support. Together, the state and federal government pay for the coverage, which expired Sept. 30.

Many families have been left in limbo, wondering if Congress will reauthorize the funding before the money runs out, leaving their child without health care coverage.

That has parents such as Kristeena Wallace worried.

Both of her children rely on coverage through the state’s CHIP program.

Her son, Johnathyn, 14, is deaf in one ear, and her daughter, Jayda, 13, has asthma.

“We wouldn’t be able to afford good health care” without CHIP coverage, she said.

Her children used to be on her health insurance plan, which she receives through her work as a dental assistant at Central Ozark Dental. But her son recently had to go through a battery of tests including MRIs and CT scans related to his hearing, and it left her and her husband with significant bills.

Her colleagues mentioned that her children could qualify for CHIP coverage through the state.

They did. Each month she pays a $231 premium for the coverage. However, she has no other out-of-pocket expenses related to their care, she said.

“If we lost the CHIP program we would really be hurting,” Wallace said.

She’s also unclear on when the funding is expected to run out. The health plan that administers care for her children sent a letter once, but with vague details.

And if the state is going to run out of funding, she’s confused on what is happening to her premium dollars.

“Where is that money going if you don’t have money to fund my kids?”

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Samantha Liss • 314-340-8017

@samanthann on Twitter

sliss@post-dispatch.com