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As Congress deliberates over funding for children’s health insurance, Missouri makes plans

Washington University announced a medical apprenticeship program, which will teach medical assistants to draw blood and do other clinical tasks.
Rici Hoffarth | St. Louis Public Radio

As Congress deliberates over whether to renew funding for children’s health insurance and community health centers, the delayed decision is forcing local agencies to make contingency plans.

The funding represents $3.4 million for the nonprofit Myrtle Hilliard Davis Comprehensive Health Centers in St. Louis.

“For us, it’s a possibility that we would have to close one of our sites,” MHD spokeswoman Deneen Busby said. “It would be about 60 employees impacted.”

Since Sept. 30, federal funding for community health centers has slowed to a trickle of stop-gap grants. States are running out of reserves for the Children's Health Insurance Program, which serves millions of low-income and disabled children. Republicans have attached both to a stop-gap federal spending plan, but it includes cuts to other public health spending that Democrats may be unwilling to accept.

In Missouri, CHIP covers about 90,000 children. If federal lawmakers can’t make a deal, the state may have to use $64 million in its own funds or cut 25,000 children out of the program, health economist Tim McBride said.

“It’s a terrible situation, it’s just dumb federal policy,” McBride said. He is chairman of the oversight committee for Missouri’s Medicaid programs. “Covering kids is really cheap in the short run and pays off a lot in the long run — in terms of better health outcomes, better school outcomes, everything.”

Different states are slated to run out of reserve funding for CHIP at different times. Medicaid analysts estimate that Missouri will run out by March of 2018 if funding isn’t renewed.

Missouri’s CHIP program covers kids in households up to 300 percent of the federal poverty level, with income-based premiums up to $231 for a family of four. Children in homes with higher incomes are most likely to be cut off if funds run out, because the state is legally obligated to offer coverage to kids in households below 150 percent of the federal poverty line.

 Follow Durrie on Twitter: @durrieB.