By Susan Kelleher

The Seattle Times

With health-insurance coverage for 9 million of the nation’s children hanging in the balance, Washington state is gambling that Congress will step back from the brink and renew a program that covers more than 52,000 children in the state.

While a few states are letting families know they may have to find new health insurance for their children, Washington is waiting until the flow of federal money dries up along with any hope that Congress will forge a consensus to renew the popular program.

The federal Children’s Health Insurance Program (CHIP) expired Sept. 30 as the Republican-controlled Congress undertook a failed, last-ditch effort to repeal the Affordable Care Act (ACA) before a new fiscal year began.

Two months into that new year, CHIP has not been renewed, and some states are running out of money to provide coverage.

Washington is one of them.

The state hasn’t communicated that to affected families, though, because the federal government has kept the money flowing on a month-by-month basis.

Also, the program enjoys bipartisan support, and Democratic Gov. Jay Inslee doesn’t want to alarm families during the holidays for a program he expects will be renewed, according to Amy Blondin, spokeswoman for the state’s Health Care Authority, which administers the funds.

If the program is eliminated, she said, the state expects to give affected families 60 days’ notice to find new insurance.

Oregon, which expects to exhaust its federal CHIP funds this month, will use state money to continue coverage, said Gov. Kate Brown, a Democrat. “As Congress rebuffs its responsibilities, it is up to us, Oregonians, to stand up for our children,” she said.

Colorado was the first state to send warning letters to families with CHIP coverage. “We felt it was important that folks covered by CHIP understand what’s happening,” said Marc Williams, a spokesman for the state Department of Health Care Policy and Financing.

In Washington state, Blondin said the federal government sent payments in October and November, and, “We believe we’re going to get a payment for December, so that’s keeping the program sort of afloat. We’re hoping to avoid unnecessary confusion and hardship for families, especially during the holiday season.”

In fiscal 2016, Washington state received nearly $219 million in CHIP funds, according to an analysis by the Kaiser Family Foundation.

Because nothing about health care is simple, here’s some background:

The CHIP funds are annual grants given to states to help children from low-income families who wouldn’t otherwise qualify for Medicaid access medical care. Combined with state funds, the CHIP money allows states to expand their Medicaid programs or create stand-alone programs that cover children up to age 19.

Some states didn’t spend all their grant money before the program expired in September, so the federal government has been redistributing those funds to states that need it, Blondin said.

In Washington state, the money helped add 52,000 children to Apple Health Care for Kids, the state’s Medicaid program.

If the CHIP funds dry up, about 25,500 of those children in families with incomes between $52,000 and $62,200 for a family of four would no longer be eligible for subsidized coverage. The families now pay monthly premiums of up to $60.

In King County, that would mean that 5,978 children would no longer be eligible for Apple Health.

Without CHIP funds, the state also would have to kick in $8 million a month to cover the rest of the 26,500 children CHIP helped add to the Medicaid rolls or change the state law that requires it to do so, Blondin said.

U.S. Sen. Patty Murray, D-Wash., who co-sponsored legislation that created the program in 1997, attacked Republicans for not renewing the program.

“It’s shameful Senate Republicans let the deadline for this program pass, putting the well-being of millions of children on the back burner while they focused on tax cuts for the wealthy,” she said in a statement.

Despite the chaos surrounding tax-reform efforts and the wrangling over budget negotiations to keep the government open, there is reason for optimism that CHIP will not fall through the cracks.

The House has passed a bill to extend CHIP for five years, and U.S. Senate Majority Leader Mitch McConnell, R-Ky., said as recently as Sunday that CHIP should be provided for in a year-end spending bill this month.

However, Republicans will almost surely need Democratic votes to pass such legislation, and the antagonism between President Donald Trump and Democrats in Congress is so great that no one can be sure of the outcome.

Sen. Orrin Hatch, R-Utah, chairman of the Senate Finance Committee, insisted: “We’re going to get CHIP through. There is no question about that.”