Gehrke: If Congress can't agree on kids' health, then D.C. is more broken than we thought

Francisco Kjolseth | The Salt Lake Tribune The Salt Lake Tribune staff portraits. Robert Gehrke.

In case you aren’t convinced that Congress is really, really bad at its job, consider this: At midnight Saturday, the Children’s Health Insurance Program, one of the most successful and fundamentally good programs in our nation’s history, will lose its funding.

So why is a program that covers 9 million low-income children, including nearly 60,000 in Utah, and enjoys broad bipartisan support in this perilous position? Congress has been too preoccupied with attempting and failing to kill Obamacare, which would strip coverage from millions of other Americans.

As a consequence, earlier this month, Utah became the first state in the nation to send a notice to the U.S. Department of Health that it will have to cut off CHIP benefits by the end of December or early January.

That means telling parents, “No, your child can’t visit a doctor for that checkup, or get that prescription your son or daughter needs.”

Nate Checketts, director of Medicaid and Health Financing for Utah, said he thinks members of Congress have read the reports that states have months of reserves and it has reduced the sense of urgency to renew CHIP. But he also points out that as early as November the state may have to start sending the parents of children on CHIP notices that their benefits will be terminated.

Those who lose their CHIP coverage may be able to buy subsidized plans on the federal marketplace, but preparing the marketplace for that surge will take time, and even the subsidized plans are more expensive than CHIP.

Sen. Orrin Hatch, one of the original sponsors of the CHIP program, has struck a deal with leading Democrats on a five-year extension, but the bill hasn’t had a hearing, and the House version hasn’t moved either.

CHIP, unfortunately, isn’t an isolated example.

Funding for Utah’s 58 community health centers, which provide affordable health care to an estimated 151,000 low-income and working-class Utahns — 51,000 of them children — is also lapsing. Many of the centers are in rural parts of the state — Escalante, Vernal, Bicknell, Richfield and on the Navajo reservation — that have no other options.

If Congress doesn’t get its House (and Senate) in order, half of the clinics could be forced to close and nearly 74,000 patients would lose access to preventative health care, including a third of all Utahns in poverty.

“The combination of the two [CHIP funding and clinic grants] would be disastrous for our kids, and not just kids, but the uninsured and the working poor,” said Alan Pruhs, executive director of the Association for Utah Community Health.

Those repercussions would also hurt Salt Lake City’s efforts to combat homelessness, since urban clinics, including the Fourth Street Clinic downtown, would see their funding slashed, as well.

Laura Michalski, CEO of the Fourth Street Clinic and Wasatch Homeless Health Care, said services at Fourth Street would have to be cut in half, staff would be reduced and medications would not be available. Hospitals and taxpayers would have to absorb $13.5 million due to uncompensated care and increased emergency room visits.

“A substantial cut in funds would be devastating,” she said. “Fourth Street Clinic not only gives homeless individuals a new lease on life through quality health care, it saves the community millions of dollars each year. It is imperative that federal funding to Fourth Street Clinic continue.”

But wait, there’s more!

Congressional inaction is also jeopardizing grants for another very successful program — the Nurse-Family Partnership. The program deploys nurses to counsel first-time mothers in their homes and make sure the mothers and infants are getting the care they need.

A University of Utah study of the Salt Lake County program released in March found a 53 percent reduction in pre-term births, a significant drop in low birth-weight babies, and a higher likelihood that the infants would see a doctor and get vaccinated.

The NFP program lapses Saturday. The state and county are looking for other ways to sustain the outreach efforts, based on the assumption that the federal government won’t be coming through any time soon.

As mentioned, CHIP can probably survive until the first of the year and community health centers have funds to stay afloat until early December. Hopefully by then Congress will replenish the funding before there is a full-blown catastrophe.

But there’s no reason it should have come to this. This is about children’s health. If Congress can’t see its way to extending these vital programs for the most defenseless in our society, then Washington is even more broken than we thought.