About 95,000 North Carolina children on a government health insurance program could lose coverage this spring if the U.S. Congress doesn’t reinstate funding for the popular program. The Children’s Health Insurance Program, or CHIP, is a victim of a Congressional budget dispute over immigration policy that’s endangering funding for children’s health insurance and other federal programs.
With the uncertainty over CHIP, some pediatricians say it’s not too early to make appointments now for checkups, vaccinations, vision tests and dental exams while the health care program is still paid for.
If Congress doesn’t restore the funding by Friday, the N.C. Department of Health and Human Services is expected to start notifying families that their children’s health insurance coverage could be cut off, at least for some families.
The agency said Wednesday that it has sufficient funding through March to provide the N.C. Health Choice, as the program is called in North Carolina. Because CHIP, created in 1997, has long enjoyed bipartisan support in Congress, its supporters are confident that Congress will ultimately find a way to continue paying for CHIP, even if funding is disrupted and some families temporarily lose coverage.
Here’s what you need to know about the CHIP situation.
Q: How many children in North Carolina are covered by CHIP?
A: About 235,000 kids, but not all are expected to lose their health insurance if CHIP isn’t funded.
Q: How can I know if my child is at risk of losing coverage?
A: You can tell by your child’s age. In North Carolina, children between the ages of 6 and 18 who are on N.C. Health Choice are the ones at potential risk of losing coverage. At last count, that’s 95,395 kids who are enrolled in N.C. Health Choice. (Those who are safe from cuts are children age 5 and under who are insured in CHIP through Medicaid, an entitlement program whose funding is separate from the current budget fight in Congress.)
Q: Would all kids on N.C. Health Choice lose health insurance when the state runs out of funds?
A: Eventually, yes, but DHHS officials would prioritize families according to seniority and need. To stretch funds, the state would likely first freeze enrollment for new families and cut off families with higher incomes. N.C. Health Choice is currently open to kids in households with incomes above 133 percent and up to 211 percent of the federal poverty level – that’s between $31,721 and $50,324 a year for a family of four.
Q: What does CHIP cover?
A: Medical, vision and dental; it’s a comprehensive health care program for children in families that earn too much money to qualify for Medicaid.
Q: What kinds of medical services should I be thinking about now?
A: David Tayloe Jr. of Goldsboro Pediatrics suggests annual physical checkups and vaccinations. Tayloe, whose practice sees more than 20,000 children eligible for Medicaid and CHIP, says vaccinations for older children can easily cost more than $100 per shot. The vaccinations typically given to children between the age of 11 and 16 are for meningitis, whooping cough/tetanus/diphtheria, and the human papillomavirus, which can lead to cancer. Tom Vitaglione, a senior fellow with N.C. Child, an advocacy group, recommends vision tests, eyeglasses, dental checkups, dental cleanings, fillings and dental cleanings in addition to vaccines.
Q: Why hasn’t my doctor contacted me? Why are public health officials not getting the word out about this?
A: They are waiting to see if Congress restores funding this month. Officials do not want to cause unnecessary alarm by panicking families over a situation that could be fixed in several weeks. If Congress fails to act this month, state health officials will have sufficient funding to run the children’s health insurance program until spring, which is enough time to start notifying the public.