Even more worrying, after partisan squabbles allowed the program to lapse September 30, is that "it's unclear how long [that funding] will actually allow all states to continue operating their CHIP programs", warns the National Academy for State Health Policy.
The months-long failure on Capitol Hill to pass a long-term extension to CHIP, which provides health coverage to 9 million lower-income children, portends serious health consequences for many of them.
The report suggested it may be hard to accurately predict exactly when funding will run out because Congress has tinkered with the rules used to redistribute unspent money to states. An analysis by the CBO last week found that a five-year CHIP extension would cost $800 million, substantially less than previous estimates.
Lawmakers in the House Energy and Commerce Committee previously fought over how to pay for CHIP, but Committee Chairman Greg Walden, R-Ore., said the reduced cost estimate would eliminate many roadblocks.
While members of Congress on both sides of the aisle insist that CHIP must be reauthorized, GOP leaders have yet to even schedule a vote, and the program has been stuck in limbo for months amid disagreements about how to pay for it. Part of the problem is they haven't been told by CMS how it will disburse money from the agency's so-called redistribution pool.
Since 1997, CHIP has provided healthcare to millions of Americans and helped to drastically reduce the uninsured rate of children.
Had that accident happened this year, though, Natali, 50, of Aliquippa, Pa., might be scrambling. She can't afford private coverage for her two children on her dental hygienist pay.
"It's creating a lot of anxiety about not having insurance and the kids getting sick", she said.
"There could be as long as a six year authorization of CHIP", stated Caroline Thorman, Rep. Hill's communication director, "but Rep. Hill and his colleagues are ironing out the details". "That's covered by CHIP". "We should stop the uncertainty and permanently extend CHIP".
Pennsylvania officials sent a notice to CHIP providers in late December - who then sent it to enrollees - saying it would have to end the program in March unless Congress acts. "They might not have a family physician, or a clear support system".
Keeping kids healthy should be a top priority, he said. "We're going to have lower coverage for parents than we used to".
Williams said in her e-mail that the $135 million now won't be immediately needed because of the December spending bill. "They seem so cavalier about it", she said. The budget office says that provision and a separate change to insurance regulations by the Trump administration will reduce the cost of insuring children.