Gov. Brian Sandoval said this week that Congress’s failure to reauthorize federal funding for the state’s children’s health insurance program has created a “critical” situation, even as it appears the federal government will grant the state several million dollars in extension funds.

In letters to Nevada’s congressional delegation sent Tuesday, Sandoval reiterated his support for continued funding for the Children’s Health Insurance Program (CHIP), a state-run program backed by federal dollars that has remained unfunded since the end of September. CHIP provides low-cost health insurance to roughly 9 million children nationwide under the age of 19 whose families exceed the income limits for Medicaid but still need help paying for insurance.

Some of the children currently enrolled in the program are receiving treatment for serious medical conditions that could be “jeopardized” if funding for the program ends or if there are gaps in their eligibility, Sandoval said.

Nevada’s version of the program, known as Nevada Check-Up, covered 27,124 children as of May, and nearly 69,000 Nevada children were enrolled in the program at some point over the last year. Nevada covers an additional 13,000 children per month through an expansion of its Medicaid program.

Earlier this month, state officials requested $11.3 million in redistribution funding, unspent federal allotments for the program from prior years, from the federal government to continue to operate its CHIP program until February. The Centers for Medicare and Medicaid Services (CMS) approved $5.6 million in additional funds for December and January, according to a letter sent to the state dated Friday.

“The State made the request for federal redistribution funds in order to protect kids and families in the short term and I am grateful that CMS approved this appropriation, however the State needs a permanent fix,” Sandoval said in a statement.

Nevada’s four House members sent a letter to CMS Administrator Seema Verma last week urging the agency to award Nevada the requested $11.3 million in redistribution funds, saying such funding is necessary “to prevent dire coverage gaps for Nevada’s children.” They blamed congressional leadership in both chambers for failing to act on legislation to reauthorize funding for the program.

Five states — Minnesota, Arizona, Washington, California and Oregon — had been awarded redistribution funding as of October 31. Minnesota and Arizona had used last year’s CHIP funding in October and are expected to run out of redistribution funds in December. Funds for the other three states are expected to allow them to continue the program until January.

Nevada and 27 other states are projected to run out of funds from last year and redistribution funds by March. Nineteen states are expected to have enough money to last until June at the latest, while Illinois and Wyoming might be able to make it through the summer.

“At this point the situation is critical,” Sandoval said. “The authorization of this funding is urgent.”

Sandoval urged the six members of Nevada’s congressional delegation, all who support reauthorizing funding for the program, to “act to preserve this critical program.” Nevada has been relying on last year’s award to continue operating the program past the Sept. 30 reauthorization deadline but will run out of those funds on Dec. 15, hence the need for the redistribution funding.

The governor also noted that an initiative backed by Nevada’s CHIP program is currently providing behavioral health and early intervention services to 600 at-risk youth between the ages of 10 and 18. The outcomes of the initiative could “pave the way” for the federal government to allow states to fund pre-diagnostic services for vulnerable children, but the initiative could be eliminated if CHIP funding ends or is redistributed, Sandoval said.

“This will directly impact the 600 children and end the chance to prove a population based approach to addressing this issue,” Sandoval said. “We will lose the opportunity to prove that intervening early with this population can prevent negative outcomes and help these children become productive citizens.”

The House voted to pass a bill in early November to extend funding for the CHIP program for five years. Reps. Ruben Kihuen and Dina Titus, both Democrats, joined 172 other representatives in opposing the bill, criticizing several provision in the bill that they believe would undermine the Affordable Care Act though they support reauthorizing CHIP funding. Nevada’s third House Democrat, Jacky Rosen, voted for the bill saying that it had “serious flaws” but that she “could not in good conscience” oppose renewing the program.

The House bill also extended funding for federally qualified health centers, which treat patients regardless of their ability to pay in medically-underserved areas, for two years. Funding for the health centers also dried up on Sept. 30.

The Senate Finance Committee passed a separate CHIP funding bill last month without funding for federally qualified centers or funding offsets included in the House bill. The bill has not yet come to the floor of the Senate for a full vote.

Gov. Sandoval letters to congressional delegation re: CHIP by Megan Messerly on Scribd

CMS Approval Letter to Nevada by Megan Messerly on Scribd