CHIP’s

CHIP’s budget lapsed 23 days ago. Congress has done nothing.

Updated by Sarah Kliff

The Children's Health Insurance Program provides coverage to 9 million low- and middle-income children.

It has now been 23 days since the federal government let the program's funding lapse — with no clear resolution in sight.

This is an unprecedented moment for the CHIP program. Giving health insurance to low-income children is not controversial. The program has never courted the same controversy that the Affordable Care Act has. Instead, CHIP typically has widespread bipartisan backing among legislators on both sides of the aisle. Bills to expand CHIP typically pass with wide margins.

But in 2017, CHIP has — somewhat surprisingly — become less of a priority. The program's budget lapsed on September 1, and there has not been a rush on Capitol Hill to fix it.

The program's structure does allow some wiggle room. Most states have money left over from the last appropriation, in 2015, to keep the program up and running. There is no evidence that any children have lost coverage yet because of the funding lapse.

But we're getting closer and closer to a turning point. Because the longer Congress goes without funding CHIP, the less money state programs have to continue their coverage. Politico reports that there are already five states that have received emergency funding to keep their CHIP programs up and running.

This ranges from a $3.6 million grant to Minnesota to a $177 million grant to California. Most of the states receiving this funding say they now have enough money to run the program through the end of the year, but make no guarantees after that. And some of these states are statutorilyrequired to shut down their programs if the federal funding comes to a halt.

Both the House and the Senate have bills to extend the CHIP program. But the House bill contains controversial offsets that would cut the Affordable Care Act and Medicare. This has left the CHIP debate at a standstill, with no clear resolution in sight.

And if CHIP isn't funded soon, it is going to leave states with some tough decisions. Do they put a halt on enrollment? Do they send letters to CHIP families, letting them know that the program may sunset at the end of the year, as Utah has proposed? On the one hand, this would give families time to make other plans if the funding doesn't come through. On the other, it could create false panic if Congress does finish CHIP funding in the next few weeks.

These aren't theoretical conversations for states They are very real. They affect millions of vulnerable children — and are only happening because Congress hasn't acted.