WACO, Texas (KBTX) Soon, perhaps even still this week, 9 million American children, more than 400,000 of them in Texas, could lose their health insurance if Congress fails to act to fund the Children's Health Insurance Program, or CHIP.
CHIP provides health insurance for children from low- and middle-income families, and for some pregnant women, and Congressional authority to fund it ended Sept. 30.
Since then programs across the nation have been limping along on reserves, but experts say if Congress doesn't act soon to fund the program, it will be too late.
The U.S. House on Nov. 3 voted to re-fund the program and sent the issue to the Senate where it still rests.
Paying its own way, that is without federal financial support, CHIP funds in Texas should last through January 2018, according to the Texas Health and Human Services Commission, (THHSC), and Congress promises it will have the program funded before then.
But looming is the threat affected families fear – that they'll get a letter from the state that says their CHIP accounts are closed and there is no insurance for their children.
Laticia L. (her last name intentionally withheld), from Bell County, has three children ages 11, 9, and 6, the older are boys, the younger a girl.
She explained in a Thursday telephone interview from her workplace that her family depends on CHIP to keep her children healthy.
"I cannot afford to buy insurance for them but we don't qualify for Medicaid because we make too much money, so without CHIP my children would go without a doctor," she said.
The children don't have any congenital health issues, but they're kids and they catch cold and cut fingers and scrape knees and they need regular medical checkups.
"We would just have to go without or just not pay the hospital bills," she said.
They're certainly not alone.
The most recent data provided by the state shows in July 2017 Texas served 400,506 children total, of whom 29,106 were new enrollments, 9.535 were renewals and a total of 27,486 cases had been unenrolled.
Closer to home CHIP covers 650 children in Coryell County, 3,191 in McLennan County and 3,798 children in Bell County, according to data provided by THHSC.
Texas state Rep. J.D. Sheffield, R-Gatesville, is one of the few physicians who serves in the Texas Legislature and he said in a Thursday telephone interview that during the most recent past session CHIP wasn't a big topic on the Texas House floor.
"It's frustrating because entitlement programs, whether they're helping kids or old folks, have a bad connotation (in Austin)," Sheffield said.
The particular issues with CHIP and the lack of attention paid in Austin were: "Number one, it's a federal program, but second, with health programs, no matter what, the opponents try to tie the issue to Obama Care, which leaves a bad taste in everybody's mouth."
In his early family practice days Sheffield said he treated lots of children who were insured by CHIP, "but as a doctor gets older, his patients get older, too, so I don't see a lot anymore.
"I think people would be shocked if they knew how many children live below the poverty level right here in their own back yard," Sheffield said.
To not re-fund CHIP "would be the perfect example of letting Texas children fall through the cracks," Sheffield said.
"States don't want to have to disenroll their kids," but "there may come a time when [they] have to send families letters" letting them go," said Maureen Hensley-Quinn, senior program director at the National Academy for State Health Policy, a non-partisan group that advises states on health policy
She was quoted in an Oct. 2 Texas Tribune article by Matthew Choi and Abby Livingston.
CHIP was created by the federal government in 1997 and two years later Texas signed up.
It made an immediate impact witnessed by data that showed in 1997 15 percent of U.S. children had no health insurance but that number fell to 5 percent by 2015.
The program also provides benefits for almost 40,000 pregnant Texas women.
CHIP covers children who live in families that make too much money to qualify for Medicaid but can't afford to purchase market insurance.
Texas senior Sen. John Cornyn said during a committee meeting on Oct. 4 that "I'm glad we're taking this important step toward reauthorization of the Children's Health Insurance Program. This is a unique piece of legislation because it does enjoy such broad, bipartisan support. And it's a good example of how providing states with flexibility and resources in the form of block grants can be successful in improving health coverage and outcomes."
But through Thursday the Senate had taken no real steps to resolve the lack of funding.
Texas Sen. Ted Cruz had not responded Thursday to a request for comment on the issue.
Together Medicaid and CHIP insure 45 percent of all the children living in the State of Texas.
The most recent data available from the federal government show in Congressman John Carter's 31st District, which includes the portion of Austin located in Williamson County and most of the fast-growing northern suburbs of Austin, as well Belton, Temple and a portion of the area surrounding Fort Hood, of the roughly 180,000 constituents, 23 percent of children and 5 percent of adults receive CHIP benefits.
The same report identifies 36 percent of children and 4 percent of adults are enrolled in CHIP programs in Congressman Bill Flores' 17th Congressional District, which includes Bryan-College Station and Waco.
Finally, 20 percent of children and 4 percent of adults in Congressman Roger Williams' 25th Congressional District are served by CHIP in places like Gatesville and Copperas Cove and Brownwood.
"The House did its job and voted to reauthorize CHIP funding on Nov. 3, and it now awaits a Senate vote," Williams said when asked to comment on the issue on Thursday.
Carter echoed saying: "The House has done their work. We passed a fiscally responsible Children's Health Insurance Program reauthorization bill with bipartisan support on November 3rd.
"It included a 5-year extension of CHIP, which will provide the more than 8 million low-income children across our country stability.
"It's now up to the Senate to do the right thing, so we can make sure that our children are taken care of," Carter said.
Flores also urged senators to act to fund the program.
“The Children’s Health Insurance Program (CHIP) provides Texas children with the health care they need to flourish and grow,” a statement from Flores said.
“The reauthorization of this important program was held up by House and Senate Democrats throughout the summer and into the fall.
“In light of their delay tactics and political games, House Republicans elected to move forward and the House passed the Championing Healthy Kids Act on Nov. 3,” Flores wrote.
“This bill, which was passed on a bipartisan basis, reauthorizes funding for CHIP as well as Community Health Centers.
“I continue to urge the Senate to follow the lead of the House and quickly pass this important bipartisan bill.
“With many states facing funding shortfalls in the coming months, it is crucial that the Senate act on legislation that President Trump can sign into law to provide certainty for children and the families
Texas hasn't acted yet, but Colorado did on Monday when the state's health service office announced it would begin sending out letters to CHIP enrollees that explained their options if the program really went unfunded and had to shut down.
Colorado projected its reserve would last through the end of January and after that the state's 167,000 enrollees would be without coverage.
The state's health professionals warned such a thing could happen if the matter continues to go unresolved.
But in Texas officials remain optimistic.
Based on our conversations with CMS (the Centers for Medicare and Medicaid Services) yesterday, we are confident that a redistribution of funds ($90M for Texas) will happen, which will allow the program to continue through February for Texas," Carrie Williams, chief press officer for THHSC said Thursday.
"We are hopeful that we will know for certain sometime in December.
"We're closely monitoring congressional efforts to reauthorize the program and are hopeful that it will be extended prior to the exhaustion of our current allotment.
"Without congressional action, we estimate we'll be covered through Jan. 31," she said.
Williams explained CHIP is paid for by a combination of state and federal funding.
For CHIP to continue in Texas, Congress must pass a law to renew federal funding for the program.
"Under Texas state law, HHSC must terminate the CHIP program when there are no longer federal funds available and must provide families with a notice of termination of CHIP eligibility no later than 30 days before the date the child's eligibility terminates," Williams said.
"If the program is not renewed, HHSC will also send all children receiving CHIP to the Marketplace via an account transfer."
The Texas Tribune article pointed the finger straight at Washington, D.C.
"Congress last renewed the program's approval in 2015 to last until the end of the 2017 fiscal year, which ended Sept. 30. Members of Congress had discussed voting to renew the program but did not do so in time for the new fiscal year. Why the program lapsed remains unclear outside of House GOP leadership. Even rank-and-file Republicans were unsure of why, a GOP Congressional aide told the Tribune."
Newspaper editorials across the country are pounding on Congress to close the pending gap: "What started as a nagging concern when Congress failed to meet a Sept. 30 funding deadline has turned into a frightening crisis.
"This time it's on the backs of children, including those still suffering Hurricane Harvey's aftermath.
"This is a heartbreaking crisis of Congress' own making. Fix it now," said the Dallas Morning News on Tuesday.
New York Magazine said: "At the end of the day, the GOP believes that it's more urgent to deliver tax cuts to corporate America than to guarantee health care to working-class children.
"And so Colorado parents will just have to wait and worry, while Republicans work to give Charles and David Koch what they paid for."
"Is there any more poignant example of how Congress' wasteful partisanship affects ordinary Americans? It's hard to imagine one.
"If the lawmakers can't act in support of a program that was enacted in a spirit of bipartisanship and serves the most truly defenseless members of society, there's no hope for them," the Los Angeles Times.
Medical and insurance industry professionals are singing the same song, but Congress hasn't yet heard the chorus.
The bottom line is, if the Senate, and therefore Congress, fails to act, and very soon, there will be millions of "on the edge" American children, maybe yours or some living in your neighborhood, who'll go without basic health care and that, say experts, is "absolutely inexcusable".