By Amanda Litvinov
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Health care coverage for nine million children is at risk, because funding for the Children’s Health Insurance Program (CHIP) expires tomorrow and Congress has not reauthorized it.
CHIP was designed specifically to cover children whose families do not qualify for Medicaid, but cannot afford private coverage.
Signed into law in 1997 with strong bipartisan support, the program helps families with modest incomes access health services for their kids by keeping out-of-pocket expenses lower than they would be under other plans. More than half of the 9 million children served by CHIP are eligible for services provided in their schools through state Medicaid programs.
Karen Slade, a teacher’s assistant at Southern Alamance High School in Graham, North Carolina, knows first-hand how critical in-school health services are. She works with multi-needs students in the school’s Exceptional Children program.
“Our students all have different challenges,” Slade said. Some of those challenges are physical, and some are cognitive. They might require occupational therapy, speech therapy, physical therapy, medications or feedings, or a device that enables communication.
“For some students, school is the only place that they’re going to see the specialists we provide. They evaluate our students and start them on exercises and routines that the staff continues until their next visit,” said Slade, who has worked in public schools for nearly 20 years.
Prior to the beginning of each academic year, school districts commit to the necessary staff and contracted services—for example, speech-language pathologists, audiologists, occupational therapists, school nurses, and mental health professionals.
Although the details of each state’s CHIP program may differ, the bottom line is that without the federal funding, many states will be unable to continue providing services at the same rate.
North Carolina, where Slade works, is one of four states that will exhaust CHIP funds in December if the program is not swiftly reauthorized. Arizona, California, and Minnesota are the other three, according to the Medicaid and CHIP payment Access Commission.
Another nine states are likely to exhaust their CHIP funding by the end of the year: Connecticut, Hawaii, Idaho, Mississippi, Nevada, Oregon, Pennsylvania, West Virginia and Utah, according to a Kaiser Family Foundation report.
Since 2015, the majority of children attending U.S. public schools are from low-income families. But the number of uninsured children is at a record low: Thanks largely to Medicaid and CHIP, around 90 percent of children are covered.
To preserve that progress, the Save Medicaid in the Schools Coalition—a national coalition of 35 organizations that includes the National Education Association—is urging Congress to extend CHIP funding for five years at current levels.
“Any delay or a failure to immediately extend funding for CHIP will jeopardize coverage for children who are eligible for school-based health services leading to immediate and lasting harmful effects for America’s most vulnerable citizens,” the coalition wrote in a Sept. 5 letter to Congress.
“Without a CHIP extension, every child educated in school districts across the country will feel the pain. No district’s financial obligations and mandate to address a child’s health needs goes away simply because CHIP funds disappear…. The failure to continue CHIP funding would merely shift the financial burden of providing services to the schools and the state and local taxpayers who fund them.”
Karen Slade is troubled to think that Congress’ inaction could mean that children will lose health coverage and the school-based services they need.
“We can’t deny our students the right to the best possible education that we can provide, and for some that means helping them meet health-related challenges,” said Slade.
“We must do everything we can to help these kids gain the life skills they’re going to need.”