Funding for children’s health insurance at risk in Iowa, nationwide

Iowa has enough money for the Children's Health Insurance program to continue at least through March, but an official said this week that if funding runs out, the state would face 'significant policy and fiscal implications.”

Known as CHIP at the federal level, the health insurance program covers about 9 million kids nationwide in low- to moderate-income households. But the program expired last weekend as Congress failed to pass an extension.

In Iowa, about 60,000 children get health insurance with CHIP funding, with 44,000 on the Healthy and Well Kids in Iowa, or Hawk-i, program. The rest are covered under Iowa's Medicaid expansion.

Families who qualify for Hawk-i pay from nothing up to a maximum of $40 a month, depending on income, for the health coverage.

The law does allow unspent funds from previous years to carry forward, so states currently are relying on those accounts. But some states are in better shape than others with those funds.

Matt Highland, a state Department of Human Services official, said Iowa has enough money to last through March. If Congress does not act to renew the program and there are no other allotments, funding would be depleted sometime in the quarter ending June 30.

In contrast, John Hoffman, spokesman for the Illinois Department of Healthcare and Family Services, said the program could continue there nearly a year.

The CHIP program has tended to have broad bipartisan support. But extensions increasingly have been short-term, which has been frustrating to advocates and health care providers. In 2013 and 2015, Congress approved only two-year extensions.

Rep. Dave Loebsack, D-Iowa, is on the House Energy and Commerce Committee, which oversees CHIP, and has been pushing for a five-year extension, said Joe Hand, a spokesman.

'We're still holding out hope for a bipartisan deal,” Hand said.

The Bloomberg news service reported last week that Rep. Greg Walden, R-Oregon, said a bipartisan deal for a multiyear extension was close but that the effort to repeal the Affordable Care Act - which failed - got in the way.

If funding were to run out, it would have significant implications.

In an email, Highland said Iowa must maintain eligibility levels through 2020 for the Medicaid expansion program, but without CHIP funding those kids would have to be funded with a smaller federal contribution.

That change alone, he said, would boost state spending by $10 to $15 million.

But the state isn't obligated to continue Hawk-i funding if CHIP funding is exhausted, he said, so decisions would have to be made about its future if it comes to that.

'These potential changes to CHIP have significant policy and fiscal implications, and the department will be working with stakeholders as more information regarding federal program changes becomes available,” Highland said.

The Kaiser Family Foundation said last month it had surveyed states and that 10 replied they would run out of CHIP funding by the end of the year. Most of those were in the West.

Families in the program earn too much money to qualify for Medicaid but tend not to have enough to afford private insurance.