SIOUX FALLS, S.D. (KSFY) - Congress approved a short-term solution for CHIP, the Children's Health Insurance Program, in a spending bill that helped avoid a government shutdown, but funding is set to run out in March, unless it acts fast.
The South Dakota Department of Social Services said approximate 15,570 kids in state are eligible for CHIP each month. It provides access to free health insurance for low income families.
Washington High School nurse Carrie Clarke said she see lots of kids in her office for a variety of reasons.
"If a child's just not feeling well sometimes they don't know what the problem is," Clarke said. "They don't know why they don't feel good so they might come down and see me quite a bit."
Clarke said access to health insurance is critical for these kids because she can only do so much.
"It's already a struggle sometimes for them, transportation issues and parents have to work, so another obstacle of going through and not having health insurance just makes things even more difficult," Clarke said.
She said she can usually only treat the symptoms of things often related to underlying illnesses and does her best to get kids to the doctor when she suspects something is wrong.
"And they don't have health insurance and parents are just like, 'We can't go,'" Clarke said. "It's very frustrating when all you want to do is help them feel better. Healthy kids do better in school."
Congress just approved a spending bill that pumped $3 billion into CHIP, but the funding is only through March 2018. South Dakota DSS said it estimates its funding for those approximately 15,570 kids will run out in March too. If that happens ...
"A majority of them would transition to the Medicaid program but some would lose coverage," Sam Masten, the Medical Eligibility Program Administrator at DSS said. "They would have to go seek out that coverage through an employer, we would refer them all to the federal health insurance marketplace to assess their eligibility for advance premium tax credits and cost share reductions.
"But that would be an additional expense that they're not used to," Masten said. "There are no premiums for the CHIP program in South Dakota."
And for those families who wouldn't qualify for Medicaid, chances are, affording health insurance through an employer or through the marketplace, better known as Obamacare, wouldn't be easier either.
"The main eligibility criteria is income, so children up to 209 percent of the Federal Poverty Level (FPL) are eligible," Masten said. "To put that into more relatable terms, for a family of three that's about $42,700 a year, that's a household making about $3500 a month."
If those folks elect not to buy health insurance in 2018, they will still have to pay a penalty under the individual mandate ordered under Obamacare for not having insurance. The recent tax reform bill does away with the mandate but not until 2019, so anyone without health insurance will have to pay the penalty when they pay their 2019 taxes.
Many are hoping Congress will come up with a long-term funding solution for CHIP when lawmakers are back from holiday break.