Congress missed its Sept. 30 deadline to renew funding for two health programs for low-income people, despite bipartisan support, and now California is waiting to learn the fate of billions of dollars it needs to keep those programs going.
Lawmakers did not renew funding for the Children’s Health Insurance Program, known as CHIP, and the Community Health Investment, Modernization and Excellence Act, called the CHIME Act, which would reauthorize assistance for community health centers.
In the case of CHIP, California stands to get $2.7 billion annually; under the CHIME Act, community health centers receive more than $600 million a year in direct grants.
The state and local health clinics won't need to cut back on services just yet. State officials said there's enough CHIP funding on hand to last until the end of the year. The U.S. Health Resources and Services Administration, which provides federal grants to community health centers, said it expects current funding will also last through December.
Supporters hope Congress will vote on bills to renew both programs in the next couple of weeks.
"States can’t fund children’s health coverage on promises. They need the funding to come through and they need it now," said Kelly Hardy, senior managing director of health policy for the advocacy group Children Now.
In California, the Department of Health Care Services uses CHIP funding to expand Medi-Cal coverage to two million kids in the state whose parents make about two-and-one-half times the federal poverty level, which is too high to qualify for Medi-Cal. The program also covers pregnant women.
"To the extent Congress fails to extend CHIP funding, the Administration would work with the state Legislature and [the Centers for Medicare and Medicaid Services] on contingency options, based upon federal guidance and direction," Health Care Services said in a written statement.
A loss of CHIP funding would mean a cut to provider reimbursement rates, predicted Lara Khouri, senior vice president and chief strategy officer at Children’s Hospital Los Angeles.
"If that was substantial enough, we’d be in a situation where we’d have to look at our programs," she said.
Community health centers say they would also have to make cuts to their staffing and programs. The nonprofit clinics serve mostly Medi-Cal and homeless patients and the uninsured, including those in the U.S. illegally.
Andie Patterson, the director of government affairs for CaliforniaHealth+ Advocates, said it would be hard for clinics to recover from a loss of any funding, since they run on tight budget margins. Community clinics employ more than 30,000 people in the state, she said.
"It makes no sense to create all these delays and uncertainty in the health care industry, but also in local economies and in local health care settings," she said.
Some health advocates blame the last-ditch effort to repeal Obamacare for steering lawmakers' attention away from the CHIP and CHIME deadlines.
"We had a line of sight to bipartisan support for CHIP before the Graham-Cassidy bill got put on the table," said Khouri. "And unfortunately, we feel that folks were distracted from something that was a clear and shared imperative."