Alabama announces freeze on children’s health program

By Shelley Connor
21 December 2017

On Monday, Alabama parents whose children depend upon AllKids—the state’s Children’s Health Insurance Program (CHIP)—received devastating notices. The program would stop enrolling children as of January 1, 2018, the notice stated; furthermore, the entire program will be terminated on February 1 should Congress fail to earmark funding for CHIP.

Alabama was the first state to announce enrollment freezes and possible closure, but a total of 9 million children are threatened nationwide by the failure of Congress to provide new funding for the program for the fiscal year that began October 1. The program allows children in families with low or moderate incomes, who would not qualify for Medicaid, access to affordable medical care with low copays.

Currently, 84,000 children in Alabama stand to lose health coverage in February. Cathy Caldwell, the director of the AllKids program, told reporters on Monday that the program’s closure would have devastating effects on many families in Alabama. According to Caldwell, prior to the institution of CHIP in 1997, one in five Alabama children were uninsured. Today, the number is down to 2.4 percent.

Randi Carter is a mother of three children in Bessemer, Alabama, just outside of Birmingham. With a single income supporting her family, she and her husband have relied upon the ACA market place for insurance; their children received care through Medicaid. When her husband received a modest pay raise this year, she knew that the children would no longer qualify for Medicaid, but would be eligible for AllKids.

This was welcome news to Carter; although she had kept up with Congress’s dilatory treatment of federal CHIP funding, she was eager to leave the chaotic administration of Medicaid behind. Few Alabama doctors accept Medicaid; by contrast, many welcome AllKids, which is administered for the state by private insurer Blue Cross/Blue Shield of Alabama.

The notice from AllKids came at a particularly bad time for the Carter family. Just the week prior, Randi had taken their five-year-old daughter to the doctor with complaints of a sore throat and a stomach ache. Within 30 minutes of arriving at the doctor’s office, an ambulance had been called, and Randi’s daughter was whisked to Children’s Hospital in Birmingham.

Randi watched anxiously as doctors conferred over the best treatment for her daughter. Several rounds of bronchodilators had not helped her to breathe easier, and doctors worried that her lungs might collapse. Her right lung, in particular, was in danger of perforation. It took three days for her condition to stabilize. She was diagnosed with asthma, a condition that she’d never had symptoms for prior to her surprise attack.

Randi was required to attend a class on asthma with other parents before her daughter was released from the hospital. The nurse leading the class showed them how to use the inhalers and spacers, a short, plastic tube that helps the aerosolized medication in the inhaler make it into a child’s airways. She cautioned the parents to keep up with the spacers. “Just the spacer for the inhaler, is $200 for that piece of plastic,” Carter told WSWS reporters.

The Carters were able to find a plan that would cover their children as well as them, but at considerable cost and uncertainty. “The plan we had this year is not being offered for 2018,” she said. “I was already frustrated and then we had a medical emergency. I didn’t get to check to see if the Blue Cross plan we picked covered this ... how much is Qvar going to cost us that we have to take two times a day?”

Qvar is the inhaler the doctors prescribed for Randi’s daughter. Prices for an inhaler begin at nearly $185. Healthcare costs will become more difficult for the Carters; Randi herself is being treated for an autoimmune disorder.

Since Alabama announced the imminent closure of its AllKids program, other states have notified CHIP participants that their benefits hang in the balance, too. On Tuesday, the Connecticut Department of Social Services sent letters to families using CHIP. “Congress has not acted to continue the funding, so we must plan to end the CHIP program on Jan. 31,” they told residents. Colorado sent a similar letter.

According to a survey conducted by the Kaiser Family Foundation, 16 states are expected to exhaust their federal CHIP funds by the end of January. In addition, 21 states are projected to run out of CHIP funds by the end of March.

As millions of American children stand to lose insurance, the House of Representatives has sent a tax bill giving the USA’s wealthiest citizens trillions of dollars in tax cuts. Earlier this month, Senator Orrin Hatch, a Utah Republican, responded to questions regarding CHIP on the Senate floor.

While acknowledging that CHIP had done a “terrific job,” he stated, “The reason CHIP’s having trouble is because we don’t have money any more.” Hatch went on to frame the crisis as one of laziness on the part of the working class. “I have a rough time wanting to spend billions and billions and trillions of dollars to help people who won’t help themselves, won’t lift a finger and expect the federal government to do everything,” he went on to say.

Hatch has claimed that CHIP will be funded. The Republican stop-gap plan for funding the program, however, does so at the expense of charging higher premiums for some Medicare beneficiaries and cuts to the Prevention and Public Health Fund, which provides 12 percent of the Centers for Disease Control and Prevention’s yearly budget.