NEWS:  Loss of federal program could more than double uninsured S.C. children

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By Lindsay Street, Statehouse correspondent  |  Congressional inaction could cause an estimated 70,000 children in South Carolina to lose health insurance coverage, increasing the number of uninsured children by about 160 percent.

Statewide today, there are about 44,000 South Carolina children without health insurance.

In 2016, 96 percent of South Carolina children had health insurance, thanks to in part to the federal Children’s Health Insurance Program (CHIP).  It extends free child medical coverage for families that make too much to qualify for Medicaid but still make below 208 percent of poverty, which equates to a family of four earning less than $55,000 per year. The gap coverage extends to about 70,000 children, according to advocates.

“We do a really good job in South Carolina in providing coverage to kids,” said Shelli Quenga, director of programs at Palmetto Project, a nonprofit that advocates for health coverage in South Carolina.

Health insurance for children is a foundational metric of child well-being, according to Bett Williams, chief communications officer for Children’s Trust of South Carolina, which focuses on care of children.

“Health insurance means that children are more likely to remain healthy, active and in school,” Williams told Statehouse Report in a statement. “Families also make fewer costly visits to the emergency room and insurance works to protect families from financial devastation when a child experiences a serious or chronic illness.”

She called the state’s CHIP one of the “proactive positive health policies” and said it is “a significant and important investment in our future.”

In South Carolina, the federal government allocated $154.2 million to run the program in 2017.  Prior to a few years ago, the state had to provide a 20 percent match to get federal CHIP funding.  But because that requirement was dropped at the last reauthorization, the state of South Carolina hasn’t had to contribute matching funds in recent years, according to Appleseed Legal Justice Director Sue Berkowitz.  In other words, the federal children’s health insurance effort is funded fully by the federal government today South Carolina.

  • NEW: After the original publication of this story, the S.C. Department of Health and Human Services responded to inquiries about CHIP funding.  We’ll provide an update next week that will provide more detail about the future of the program.

Funding in question

Now, Children’s Health Insurance Program could lose funding as soon as July 2018 in South Carolina — and sooner in other states — after Congress missed the Sept. 30 deadline to fund it. But while the Senate passed extending funding this week, partisan politics could imperil advancement of funding CHIP in the House, observers say.

“If it’s not reauthorized it will devastate health care coverage in our state. We’re talking about tens of thousands of kids,” Berkowitz said.

Quenga

In South Carolina, the exact number of children benefiting from CHIP is hard to tease since the state lumps CHIP beneficiaries into Medicaid beneficiaries. CHIP is operated under the Medicaid umbrella and has zero premiums or deductibles for beneficiaries, like Medicaid coverage, Quenga said.

Experts say the seamless integration of CHIP and Medicaid has led to the program’s success in the state, but caution it also could lead to its downfall since many families are unaware of its impact on their lives and won’t know to advocate for it.

“It’s invisible pretty much to everyone,” Quenga said.

In states where Medicaid was expanded under the Affordable Care Act, the state must continue to fund CHIP at its current level despite no federal funding, according to the Center on Budget and Policy Priorities, a nonpartisan research group. But in states like South Carolina, where Medicaid was not expanded, the state has no such obligation.

Berkowitz said the state has two options:

  • Expand Medicaid to those children in the gap and receive a 70 percent match from the federal government, or
  • Roll back eligibility — meaning families at 101 percent of poverty and below 208 percent of poverty would have to buy health insurance on the market.

A request for comment from the state’s Medicaid office, the S.C. Department of Health and Human Services, was made and received, but the office did not provide answers by the time of publication.

Program’s end could hurt kids

Soura

Christian Soura, who formerly ran the state Department of Health and Human Services, now is the S.C. Hospitals Association’s vice president of policy and finance. He said not continuing CHIP funding could cause hospitals to close, especially in conjunction with possibly losing funding for Medicaid Disproportionate Share Hospital. The financial strain on hospitals in rural areas would reach a breaking point with uninsured children as hospitals must provide medical care to those in need.

An end to the program could result in sicker children, affecting all metrics including education and economy, advocates say.

“Health insurance means that children are more likely to remain healthy, active and in school,” Williams said. “Families also make fewer costly visits to the emergency room, and insurance works to protect families from financial devastation when a child experiences a serious or chronic illness.”

Quenga added lack of health coverage could impact education in the state because sick children can’t learn.

“We don’t need to add any more problems to our education system and sick kids in school is not what we need,” she said.

Quenga said people should not take it for granted that Congress will pass the legislation needed to fund CHIP prior to it running out in third quarter of 2018.

“I don’t think we can take anything for granted any more in terms of congressional action,” she said.

Quenga predicted waiting lists, as well as nonprofits like the Palmetto Project needing to reach out into communities to find health care alternatives such as free clinics and prescription drug plans.

“We would be leaving our kids out in the cold and we’re not used to the cold,” Quenga said. “This would be a huge step backwards if we had to start limiting access to the poorest … (CHIP beneficiary families) are working people, who are the backbone of South Carolina, who are looking for health care for their kids.”

She said even a month without coverage could have wide-reaching consequences for children in the state.

“Even a small gap in coverage for a child can negatively impact their health,” Quenga said. “The potential costs are real. These are kids who need immunizations, access to inhalers … We don’t want to get any more behind than we already are.”

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