As Congress failed to reach a spending agreement on Friday night, about 1.7 million children are at risk of losing insurance coverage under CHIP by the end of February, experts say.
The Center for Children and Families at Georgetown University estimated that 24 states across the country faced Children's Health Insurance Program funding shortfalls if Congress could not reach an agreement to fund the program beyond March. In 21 of those 24 states, some children could lose coverage.
The Medicaid and CHIP Payment and Access Commission issued similar estimates (PDF), projecting that nine states and the District of Columbia will exhaust CHIP funds by the end of January, and that 27 states and D.C. will run out of funding by the end of March. If a deal isn't reached by the end of 2018, all states except for Illinois will be out of funds for CHIP, the commission estimates.
It is hard for policy analysts to fully estimate the government shutdown's impact on CHIP because there are a significant number of variables involved, including how different states can adjust their allocations, the Georgetown center's executive director Joan Alker wrote in a blog post.
The children at risk of losing coverage this year are enrolled in separate state CHIP programs, Alker wrote. The majority of children in CHIP are covered by Medicaid, so they are protected from coverage loss—but federal funding cuts have financial implications for Medicaid, too.
Several states have already notified families that they could lose coverage or that they will close enrollment, Alker wrote. While many states have pushed off immediate plans, they'll likely reopen those discussions if Congress doesn't act. Analysts expect to see action on the state level by Feb. 1 if Congress can't agree on funding by the end of January.
Alker told NBC News that another factor complicating estimates is that CHIP has traditionally had bipartisan support, and because of that has never operated under this level of uncertainty before.
"There are many, many questions, and it's very troubling that we've gotten to this point," she said. "It's an unprecedented situation. I've been working on CHIP since it was born in 1997, and I've never seen anything like this before. It's very sad."
As CHIP funding runs low, physicians are scrambling to take care of as many needs as possible, including filling prescriptions for long-term windows and working to avoid disruptions in care for conditions like leukemia.