States May Reduce Number of Children In Insurance Plan

By Christopher Lee
Washington Post Staff Writer
Tuesday, October 16, 2007

As political gridlock in Washington muddies the long-term funding outlook for the State Children's Health Insurance Program, some states are preparing contingency measures such as enrollment caps or cutting children from the rolls.

In the biggest domestic policy clash of President Bush's tenure, the House on Thursday will attempt against long odds to override Bush's veto of a bipartisan $35 billion expansion that would boost the popular program's enrollment from 6.6 million to 10 million over the next five years.

Should the override fail, the players will have to go back to the drawing board in search of a lasting compromise while the decade-old program, originally set to expire Sept. 30, continues operating until mid-November under a temporary measure that extends the previous year's funding levels.

But many state program leaders say the short-term fix will not be enough to maintain existing enrollment if gridlock continues.

"It's almost the worst situation, because it puts us in a holding pattern," said Martha Roherty, director of the National Association of State Medicaid Directors. "This is administrative reality. This has nothing to do with Republican or Democrat. This is what happens when a program is in limbo. And that's what we've done -- we've created a situation where there isn't really a program."

At current funding levels, 21 states would run out of money before the end of the fiscal year next September, according to the Congressional Research Service.

In California, which would run out in June, state SCHIP director Lesley Cummings on Friday recommended adopting emergency regulations that would allow state officials to establish a waiting list and a process for cutting off some of the 830,000 children on the state's $1.3 billion-a-year program.

"It's really critical that people understand that the amount of money this program has had in the past just is not sufficient for the program we've built and the caseload we now have," she said.

In Louisiana, as many as 37,000 of the 111,000 children on SCHIP might have to be cut to keep the program afloat, said J. Ruth Kennedy, the state's SCHIP director. In Georgia, which already has an enrollment cap of 295,000, officials are considering tightening eligibility requirements, reducing enrollment and limiting dental benefits, said Rhonda Medows, commissioner of Georgia's Department of Community Health.

"We're sitting on pins and needles," Medows said. "We can't plan past a six-week period because we don't know what's going to happen. These are children actively receiving care, and care will be interrupted."

Health and Human Services Secretary Mike Leavitt said the department has been working with governors of 49 states to make sure that no one loses coverage.

"I know that there are states out there who in the future could have problems if we don't get this solved," Leavitt said.

House Speaker Nancy Pelosi (D-Calif.) said in a statement that the matter could be resolved this week if the override succeeds, which appeared unlikely yesterday.

"The question is whether some members will continue to choose partisan obstruction or will they embrace a bipartisan compromise that will provide health insurance to 10 million children," she said.

© 2007 The Washington Post Company