States Plan To Limit SCHIP Enrollment Without Permanent Funding

Main Category: Medicare / Medicaid / SCHIP
Article Date: 27 Nov 2007 - 7:00 PDT

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Some states say that without "a stable source" of funding for SCHIP this year, they must start planning to freeze enrollment and possibly drop coverage for thousands of children, the San Francisco Chronicle reports. According to the Congressional Research Service, 21 states will run out of federal SCHIP funds in 2008, with nine states facing budget shortfalls in March 2008, if Congress continues to fund the program at current levels.

In California, officials within the next two weeks will decide whether to stop enrolling children in Healthy Families, the state's version of SCHIP, and whether to discontinue coverage for 56,600 families beginning Dec. 31 (Coile, San Francisco Chronicle, 11/25). Up to 600,000 California children could lose coverage beginning in 2008, according to estimates from the California HealthCare Foundation. Len Finocchio, a foundation spokesperson, said that current funding levels "wouldn't allow California to maintain its present caseload and keep up with inflation" (Brink, Los Angeles Times, 11/26). California officials say that they will need $1.2 billion for fiscal year 2008 to continue to enroll children at current rates.

Georgia's SCHIP, PeachCare, already is running a deficit and maintains current enrollment through an HHS grant. According to the Chronicle, health care providers in Georgia "are asking if they should cancel appointments for kids enrolled in the program, and parents are asking if they should keep paying their premiums." Georgia officials are in the process of determining which children are the sickest so that if Congress does not reach an agreement on increased funding for the program, the state can discontinue coverage for the healthiest children first. Rhonda Medows, commissioner of the Georgia Department of Community Health, said, "Georgia is on the edge of the cliff," adding, "We don't want to think about kids having cancer, but how do you schedule someone for six weeks of chemotherapy if they only have four weeks left in the program? Does the oncologist start the therapy or do they wait? How do you plan? You can't" (San Francisco Chronicle, 11/25).

Opinion Piece
Efforts to reauthorize and expand SCHIP are a "good example of one possible path to lawdom or, in this case, vetodom" because the bill "tacked so wildly through choppy waters that when it finally emerged from the fog, its hull had a completely different number," Don Wolfensberger, director of the Congress Project at the Woodrow Wilson International Center for Scholars, writes in a Roll Call opinion piece.

Wolfensberger continues, "If the issue had been a straight renewal of SCHIP, it would have easily sailed to enactment," but because Democratic leaders "had in mind an ambitious expansion that would cover millions of additional children at billions more in cost than the Bush administration requested," they needed to use "a variety of procedural devices to advance their cause." Democrats are "no closer today to a veto-proof majority but seem content sitting motionless atop an issue they hope to ride into the 2008 elections (while keeping SCHIP afloat on a continuing appropriations barge)," according to Wolfensberger (Wolfensberger, Roll Call, 11/26).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation© 2005 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

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