More than 20 states will run out of money for the State Children's Health Insurance Program, or SCHIP, sometime this year unless Congress and the White House can resolve a dispute over its funding, a new study shows.
Following a presidential veto, the Senate is working on its third version of the bill, which the White House has promised to veto once again.
The bill has been a major source of tension between the White House and Congress, with President Bush recently chastising Democrats for making what he called cosmetic changes to the to expand the SCHIP program.
"I made it perfectly clear that if you keep passing this piece of legislation, I'm going to keep vetoing it, unless, of course, it's a piece of legislation that focuses on poor children and does not expand the reach of the federal government into health care," the president said in a Washington speech to the Grocery Manufacturers Association on Wednesday.
On the Senate floor, where the bill was under consideration, Democrats, including Sen. Robert Menendez of New Jersey, were happy to return the president's fire.
"This is a president who doesn't see the irony in sticking out one hand to ask for $200 billion in Iraq this year while using the other to veto health coverage for poor American children," Menendez said.
In the meantime, Congress and the president have agreed to temporarily continue funding SCHIP at last year's levels. Only there's a problem: SCHIP rolls have grown by so much that last year's funding is not enough to cover this year's children.
A new report by the Congressional Research Service says 21 states will run out of money for the program sometime during the year, with 10 exhausting their funds by March.
Maine is one of those states. Kirsten Figueroa, the state's deputy commissioner for finance in the Department of Health and Human Services, said her staff has not figured out yet what they would do.
"We currently have 4,500 kids in that program. … We couldn't just pick certain kids and say 'you're not covered as of today,' because how do you pick one over the other," Figueroa said.
Iowa will also run out cash for the SCHIP by March. Like Maine, Iowa does not cover adults and only covers children up to two times the poverty line, or $41,000 for a family of four.
Kevin Concannon, Iowa's head of Health and Human Services, said the state plans to "look at extending or making changes in our Medicaid program to pick up some of those children who are in what's called the Mcaid expansion program."
That would cost the state more money, he said, but at least it would prevent those children from losing their coverage.
But stepping in with state money would not be an option in Georgia, another state projected to run out of funds in March, said Community Health Commissioner Rhonda Meadows.
"This state has actually laws on books that actually prevents the program to be funded 100 percent by the state," she said.
Georgia's program, called PeachCare, already went through one funding shortfall earlier this year, requiring it to freeze enrollment and take other cost-cutting measures. Meadows said that turning the on again, off again funding of the program is having an adverse impact on the covered children.
"We are talking about a disruption for children who are in the middle of (chemotherapy), who are in the middle of surgeries, who are in the middle of getting much-needed treatment for diabetes and asthma," Meadows said.
Nov. 16 is when the latest short-term funding runs out. Congress is likely to extend that for the rest of the fiscal year, but it is not clear whether there will be additional money for the states, such as Georgia, that will run out in March. And Meadows says if the money ends, so will the coverage.
"These are children who actually have on-going health care needs. They cannot plan, their parents and health care providers cannot plan, past Nov. 16 because this has not been resolved yet," she said.