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CHIP funding was supposed to last through March. It could start to run out in 2 weeks.

Coverage for millions of kids is in jeopardy.

US Capitol
US Capitol
Bill Clark/Getty Images
Dylan Scott
Dylan Scott covers health for Vox, guiding readers through the emerging opportunities and challenges in improving our health. He has reported on health policy for more than 10 years, writing for Governing magazine, Talking Points Memo, and STAT before joining Vox in 2017.

The Trump administration said on Friday that Congress’s short-term fix to keep a health insurance program that covers 9 million American children running through March could start to run out in just two weeks.

Congress has been courting disaster with the Children’s Health Insurance Program, failing to extend funding when it ran out in September. States have begged them to act, and Congress approved a package in December to help states keep running their programs through March. But the program could be in trouble again much sooner.

“We appreciate that Congress included funding for CHIP in the continuing resolution that runs through January 19, 2018,” Johnathan Monroe, a spokesperson for the Centers for Medicare and Medicaid Services, said in a statement. “However ... we are unable to say with certainty whether there is enough funding for every state to continue its CHIP program through March 31, 2018.”

Based on the administration’s estimates, the short-term CHIP money should be enough to fund all states through January 19 or possibly the end of the month.

States have already been forced to send letters to families warning that their insurance could expire without congressional action. So far, a catastrophe has been avoided through emergency measures taken by states and CMS, but they are running out of options. This short-term patch that Congress passed didn’t move the needle by much.

Republicans and Democrats want the program to be extended. Lawmakers in both parties in the Senate and the House hope to extend CHIP for five years. There are disputes between the parties over how to pay for the program, but even that problem has shrunk: The Congressional Budget Office estimates that after Republicans repealed the Affordable Care Act’s individual mandate in the tax bill, funding CHIP for five years costs only $800 million — way down from $8.3 billion before the mandate’s repeal.

(This gets wonky, but the gist is that repealing the mandate drives up premiums in the ACA markets. So if kids are covered by CHIP instead of the ACA, as many of them would be if CHIP were not extended, it’s cheaper for the federal government.)

What’s the delay? It seems to be two things. Congressional leadership is hoping to ask their members to take just one vote on a number of contentious issues, including DACA and government spending caps — and CHIP has been folded into that discussion. Because those other matters are not yet resolved, Congress has been stuck passing short-term spending bills.

Perhaps more fundamentally, the Republican-led Congress instead prioritized a last-minute run at Obamacare repeal and a major tax overhaul, while leaving the CHIP funding unresolved for more than three months. They are running out of time to fix it.

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