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Government funding bill provides long-term relief to Alabama CHIP program

Pediatricians began a few years ago dismissing some families who refused to get vaccines, but state law has taken that discretion away from them.

By Chip Brownlee
Alabama Political Reporter

Alabama’s version of the Children’s Health Insurance Program finally has some relief after months of uncertainty.

The government funding bill approved Monday afternoon by Congress and the president not only ends a short government shutdown but provides CHIP six year’s of consistent funding, putting to end months of questions over whether Alabama’s CHIP program would need to begin disenrolling low- and moderate-income children.

Funding for the CHIP program expired in September 2017 and Congress took months to come to a long-term agreement, leaving CHIP officials in Alabama wondering if they would have to kick 85,000 otherwise-uninsured children off the roles.

Nationwide, the program provides nearly 9 million children and 375,000 pregnant women health coverage.

“It’s been a long, hard fight,” said Cathy Caldwell, Alabama’s CHIP director. “I’m just glad it’s over, and I’m glad it’s for six years.”

Like many of Alabama’s public health insurance programs, one part of Alabama’s version of CHIP, called ALL Kids, costs upward of $200 million a year and could not exist without financial support from Washington.

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In Alabama, CHIP provides nearly 160,00 children and pregnant women coverage between the 85,000 enrolled in ALL Kids and another 75,000 who are enrolled in a separate Medicaid component that would have stayed around despite the loss of federal match money.

For the past two years, ALL Kids was funded entirely by the federal government through a provision of the Affordable Care Act, and when roll-over federal funding began to run out in December, Caldwell thought the state was going to have to send parents notices that their children would soon lose their insurance coverage in February.

It never happened, though, because Congress left Washington ahead of Christmas after passing a short-term funding bill that could get the program through February or March. But uncertainty remained. No one knew if lawmakers in Washington could make a deal before money dwindled for the second time.

CHIP is a normally a program that’s popular across the aisle with both Democrats and Republicans touting their support for the program, which was first implemented in the 1990s under President Bill Clinton, but its funding has been entangled in partisan budget and healthcare reform fights since last summer.

The funding approved Monday will provide $124 billion to CHIP through 2023.

“Caring for our children and meeting their healthcare needs is a bipartisan issue,” said Gov. Kay Ivey in a statement Monday. “I appreciate Alabama’s Congressional Delegation for playing a key role in ensuring continued funding for CHIP.”

But even as new funding starts to flow, damage to the program already began as uncertainty loomed, Caldwell said, as parents wondered whether to sign their kids up for the program.

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Many agree the funding is long overdue.

“Families across Alabama deserve to breathe a sigh of relief, but it never should have come to this,” said Arise Citizens’ Policy Project President Jim Carnes. “CHIP funding deserved a quick, straightforward renewal before it expired nearly four months ago. Delaying the renewal and tying it to other important issues was unnecessary and irresponsible.”

Alabama will continue receiving the heightened 100 percent federal funding for the program through this fiscal year and next. In 2019, Caldwell expects federal funding to drop to about 89 percent as the heightened match begins decreasing over two years to its pre-Obamacare levels.

In 2020, funding for the program will drop on down to the regular federal match rate Alabama, similar to the match the state receives for Medicaid — about 80 percent. Twenty percent of the costs would need come from the state’s General Fund budget.

That’s better than nothing, though. Parents of CHIP beneficiaries won’t have to worry month-to-month whether the program will still be around and if their children will be able to get the health coverage they need.

“It’s such a weight and burden lifted,” Caldwell said.

Not only can parents stop worrying, CHIP officials can get back to work. Caldwell said her last few months have been almost totally devoted to mitigation efforts and working to get funding renewed.

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“It’s going to be really nice to be able to get back to our real jobs,” Caldwell said. “The peace of knowing that our enrollees, them and their families, will not have to worry about their future and we can continue enrolling newly eligible children in the program.”


Chip Brownlee is a former political reporter, online content manager and webmaster at the Alabama Political Reporter. He is now a reporter at The Trace, a non-profit newsroom covering guns in America.

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