Congress misses health care deadline, Minnesota feels the pinch

WASHINGTON – Congress missed a deadline and Minnesota was one of the first states to pay the price.

The national Children's Health Insurance Program covers health care for more than 9 million low-income children — or it did until September, when it lapsed before lawmakers could get a reauthorization bill to the floor. Most states had enough funding in reserve to keep their programs running for several months until Congress could catch up. Minnesota, which relies on CHIP funding to provide health care for more than 100,000 low-income children, didn't have that cushion.

A $3.6 million infusion of unspent CHIP funds from the Centers for Medicare & Medicaid Services this week will keep two key programs — one that provides care for pregnant women ineligible for Medicaid, another for infants and toddlers under age 2 — funded through the end of the month.

"We cannot overstate the urgency of this situation," Minnesota Democratic Reps. Tim Walz, Keith Ellison, Rick Nolan, Betty McCollum and Collin Peterson wrote in a joint letter to House leadership on Thursday, urging a swift floor vote on reauthorization. "Without immediate action, the pregnant women covered by CHIP will be at risk of losing coverage altogether."

While none of Minnesota's Republican congressmen signed on to the letter, they echoed the call for action.

"In Minnesota, 125,000 children and pregnant mothers rely on this important health care program," Rep. Erik Paulsen said in a statement. "I have long supported its mission, voted for its expansion, and believe it needs to be reauthorized as soon as possible."

CHIP is a popular program with broad bipartisan support. But members of the House Energy and Commerce Committee argued bitterly Wednesday over how to offset the cost of the program, as well as a related fund that supports community health centers that also lapsed at the end of the month. Similar wrangling has bogged down CHIP reauthorization in the Senate.

"The House and Senate are working out small differences in their respective plans," said Republican Rep. Jason Lewis. "I support the prompt reauthorization of CHIP."

The Minnesota Department of Human Services, meanwhile, is scrambling to figure out how to cover the multimillion-dollar hole it had expected to cover with CHIP funding. The $115 million in funding that ran out at the end of September covered 125,000 Minnesota children on Medicaid, 200 babies in low-income families whose incomes didn't quite qualify them for assistance otherwise and 1,700 pregnant women, many of them undocumented and in need of prenatal care.

Repeated, failed attempts to repeal and replace the Affordable Care Act dominated Congress' September agenda and derailed CHIP reauthorization, along with many other small, popular programs.

The National Flood Insurance Program lapsed at the end of September. So did the Perkins Loan Program, which helps low-income students pay for college. The Community Health Center Fund wasn't reauthorized, leaving clinics across Minnesota bracing for the worst.

"We are really, really, really concerned," said Rhonda Degelau, executive director of the Minnesota Association of Community Health Centers, which operates clinics across the state.

The clinics have enough to keep the lights on for now — but that could change if Congress doesn't renew the program by the end of the year.

"The clinics' budgets are so small and so tight, they are being forced to make contingency plans," Degelau said. "Many of them are already looking at layoffs and having to possibly close some of their clinic sites, particularly out in rural Minnesota, which would be disastrous."

While Minnesota was one of the first states to start running low on children's health funding, it won't be the last. By March, at least half the states are expected to deplete their CHIP reserves.

The Associated Press contributed to this report.

Jennifer Brooks • 202-662-7452