When Beth Gherlein’s daughter Beatrice was about a year old, she woke in the middle of the night screaming in pain with a fever of 105 degrees and hives.
Gherlein called a 24-hour hotline accessible through the Children’s Health Insurance Program, known as CHIP, which connected her with a nurse late on a Saturday.
Beatrice also had bruising on her chest, which can be a sign of meningitis. Gherlein ended up taking her to the emergency room and Beatrice was ultimately fine, but it was critical for the family to be able to access care when they needed it without worrying about putting themselves into financial hardship.
“Kids need regular immunizations for preventative care, they get sick more often, and are more prone to accidents,” Gherlein said. “If you get sick as an adult and you think ‘I’m sick’ or ‘I’m hurt’ you can make this calculated decision that’s probably financially about if you can afford it or tough it out. It’s a lot more scary with a kid.”
Gherlein and her husband, David Tyson, get insurance for Beatrice through CHIP, a federal program that Congress failed to reauthorize funding for at the end of last month. While it’s not an immediate impact to the program here since Montana has CHIP money left over from last fiscal year, it’s enough to worry Gherlein and other families who use CHIP.
In Montana, CHIP and children's Medicaid is part of Healthy Montana Kids, a program that provides health care coverage to more than a third of children statewide. The Kaiser Family Foundation estimates the number of children covered under CHIP in Montana at 44,668.
Montana could keep CHIP operating until February before funds are exhausted, but other states could be in trouble starting in November.
One of Montana’s senators, Democrat Jon Tester, expressed frustration Tuesday that the funding expired and said some states might not be able to wait until Congress can act.
“There’s no assurance we extend this program because it’s not done until it’s done,” Tester said. “I think it speaks to the dysfunction of Washington.”
Tester said while Congress “wasted so much time debating unworkable” efforts to repeal the Affordable Care Act, all of which ultimately failed, funding for CHIP and other programs critical to Montana’s health care system (like funding for community health centers) was allowed to slip through the cracks.
An act to reauthorize CHIP is expected to be marked up in the U.S. Senate on Wednesday morning, and it appears a bipartisan agreement is in place to extend the funding. On the House side, a package that funds CHIP, as well as extend funding for community health centers, which also expired, will be marked up later in the day.
Tester doesn’t expect the Senate effort to make it out of committee this week, and the Senate is out next week. “It could happen in October, but more likely it’ll happen in November or December or maybe the first half of next year. The crystal ball is very cloudy about when it could happen on this one because it should have already been done.”
Sen. Steve Daines, a Republican, also called the program critical for Montana but was more optimistic about quick action in Congress. “The Children’s Health Insurance Program provides important coverage to tens of thousands of Montana children, and consensus exists in Congress to reauthorize the program," he said. "I am confident this will get done soon."
The newest member of Montana’s delegation, Republican Rep. Greg Gianforte, also said he expects action soon. “Tens of thousands of Montana families rely on the Children’s Health Insurance Program for their children to have health coverage,” he said. “The program has enjoyed broad bipartisan support, and I expect Congress will reauthorize CHIP soon.”
Gherlein and Tyson will be watching Washington, D.C., closely.
“I feel like I’m cautiously optimistic in the sense I do believe people don’t want kids’ health insurance to go away,” Gherlein said. “Everybody wants kids to be able to go to the doctor. I don’t think it’s in people’s best interest politically to do anything that would jeopardize the program. But the idea it just slips through the cracks and they don’t re-up the federal funding is really scary.”
She doesn't know what the family would do if CHIP was no longer funded. The couple owns their own business, Tandem Doughnuts, and Tyson works another job, but it doesn’t provide insurance. They fall into the gap of families that would not get subsidies under the Affordable Care Act to buy insurance offered on federal exchanges because they are eligible for coverage under Medicaid Expansion.
If CHIP went away, Gherlein is unsure how Beatrice would be covered.
“We could try to buy private insurance, but I honestly don’t know if we could afford it outright with no subsidies. I don’t know that we could do that plus rent. We aren’t in a place right now where we make enough money we can go buy insurance.”
Gherlein says she, her husband and her daughter are the “typical Missoula family ” — two degrees and the school loans that came with them. Her husband has a master's degree in public administration.
“We just have had a hard time finding jobs that really pay enough and also provide benefits," she said. "I feel like my family, we’re the kind of family that conservative politicians act like they want to help. We’re small business owners, employee people, we’re raising our kid.
“We can’t continue to be small business owners who own our business and employ our employees if we don’t get some help for health insurance. Now that we have a kid, it’s not the same as when I was 20 and I just wouldn’t have insurance. She needs insurance.”