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Thousands Of Alabama Children Could Soon Lose Health Insurance

DAVID GREENE, HOST:

As members of Congress plan to head home for the holidays, one piece of unfinished business is whether to fund the Children's Health Insurance Program for next year. This program helps states insure kids whose parents can't afford health insurance but make too much to qualify for Medicaid. Legislation to extend the funding lapsed this fall, leaving states to fend for themselves. And Alabama announced it will freeze enrollments and then plans to end the program if Congress does not act. Cathy Caldwell is the director of Alabama's CHIP program, and I asked her how families who use this program in her state have been reacting to this news.

CATHY CALDWELL: They are absolutely panicked, just panicked is really the best word I have. They're not understanding what's going on. They're not understanding why funding has not been extended for this very important and very popular program and really just trying to get their brains around what possible options they might have.

GREENE: In the most dire circumstances, if you do have some families who lose this support and can't insure their kids, what happens if their kids get sick? Is it going to the ER and just trying to pay on their own?

CALDWELL: Yeah. Some of them may be able to transition to marketplace coverage or employer-sponsored coverage. Even for those families, I think it is going to take a little bit of time for them to navigate the system and make that happen. So many of those will have a gap in coverage. But absolutely go to the ER, try their best to pay for any needed medications out of pocket. But I have no doubt there will be many children in need of services that they will not be able to access.

GREENE: Is your program out of money at this point?

CALDWELL: Our program is not out of money yet, but we are projecting to spend our available money and our share of the contingency pool. We are projecting exhausting all of those funds in February. And as you can imagine, to shut down a program where you have 84,000 children enrolled and you have requirements to give them some advance notice before you cut the kids off of insurance, we have to take some actions in advance. So what our current plan is is we will not enroll any new children or renew any existing enrollees on or after January 1. And then we will disenroll the 84,000 current enrollees on February 1.

GREENE: Are you able to reassure them in any way based on what you're hearing from Washington?

CALDWELL: We are telling them that we are watching activities in Washington very, very closely and that if funding is continued, we will stop, you know, all of these actions. So just trying to assure them the best we can. But at the same time, we don't really want to give false hope because January 1 is real close. And February 1 is pretty close as well. So we feel a need to be as realistic with them as we can.

GREENE: And what about you personally? I mean, I know you've probably followed debates in the federal government and in Washington before. You do have Democrats and Republicans both saying they're committed to this. I mean, are you still optimistic?

CALDWELL: I am. I'm very optimistic that Congress will extend funding. I desperately hope they do it soon before we have to take action because that will affect many thousands of children.

GREENE: Cathy Caldwell is the head of Alabama's Bureau of Children's Health Insurance. Thanks for the time.

CALDWELL: Thank you. Transcript provided by NPR, Copyright NPR.