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What Happens When CHIP Funds Run Out


We'd like to turn now to one of the main issues caught in the middle of the spending battle in Congress - the Children's Health Insurance Program, also known as CHIP. This program helps state insure about 9 million children whose parents can't afford health insurance but make too much to qualify for Medicaid. At the moment, the program is operating on a temporary funding extension that's expected to dry up in March, but several states say they could run out of funding before then. One of those states is Alabama.

And joining us now is Cathy Caldwell. She is the director of Alabama's CHIP program. She's speaking to us from Prattville, Ala. Cathy Caldwell, thank you so much for speaking with us.

CATHY CALDWELL: Oh, thank you for having me.

MARTIN: So for people who aren't familiar with the program, could you just describe briefly, you know, what it does - amplify what I said earlier?

CALDWELL: Sure. The Children's Health Insurance Program provides health insurance to uninsured children whose family income is above the Medicaid level. Currently, in Alabama, we have over 85,000 children insured in that program.

MARTIN: And how exactly does it work? Does it work like any other insurance program - people can go to the doctor that they want, go to the hospital if they need to?

CALDWELL: Absolutely. We have a comprehensive benefit package that provides a wide array of benefits for many services, including WellCare so children can get their preventive visits. They can get their immunizations. Also, (unintelligible) care certainly can go to the doctor when they're sick. We cover inpatient. We also cover mental health services, vision and dental - so a very comprehensive benefit package.

MARTIN: One of my colleagues spoke with you in December. And you said then that your state could exhaust CHIP funds in February. If those funds run out, what happens if a kid whose family has CHIP gets sick and has to go to the doctor or to the hospital? What happens?

CALDWELL: And we did receive some additional funding. But we're still worried that it's going to run out before too long. What will happen when we exhaust our funding - we will dis-enroll children from the program. Many of those children will become uninsured. So for many, they will probably not be able to access all of the services they need.

If they're sick, for example, and go to the doctor, they'll be expected to pay for it out of their own pocket. In an emergency situation, it's a - you know go to the emergency department or even an inpatient stay - the family will be expected to pay for those services which will be quite expensive. So it'll create a hardship on the family. And like I said, there will be situations, likely, where the children won't be able to obtain the services they need.

MARTIN: I'm sure you know now that we're in a bit of a standoff here and that both the Republicans and Democrats in Washington are accusing each other of holding, you know, the country hostage to this or that program. Many of the Democrats are saying that the Republicans are using this as a bargaining chip to, you know, force them to vote for something - other things that they don't agree with. I'd like to ask, how is this all striking you where you are?

CALDWELL: I would like to say that there is huge urgency. I think some people look at the numbers and think that if we still have a few weeks of funding, then there's no urgency. That is absolutely not the case. These are large programs with many children enrolled. And so if in fact funding does not continue, then we have to shut down our programs. It is going to take time and many resources to accomplish that. So we need Congress to act and extend funding. And we really need to get that down this month.

MARTIN: That's Cathy Caldwell. She is the director of Alabama's CHIP program. We reached her in Prattville, Ala. Cathy Caldwell, thank you so much for speaking with us. We really appreciate it.

CALDWELL: Oh, you're very welcome. Thanks for having me.

(SOUNDBITE OF KOLOTO'S "LIFE IN CLAY") Transcript provided by NPR, Copyright NPR.

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