The report suggested it may be hard to accurately predict exactly when funding will run out because Congress has tinkered with the rules used to redistribute unspent money to states. After last month's tax reform, CBO analysts found that funding CHIP for the next five years would add $800 million to the deficit over 10 years, rather than the $8.2 billion originally projected. "It's going to happen", said U.S. Rep. Fred Upton (R-Mich.), former chair of the Energy and Commerce Committee. However long an extension they land on, lawmakers said, all signs point that CHIP will at the very least get funded in the January 19 continuing budget resolution that Congress needs to pass to avert a government shutdown.
"If we go to six years, it may have no cost", Walden said.
And CHIP is just one piece of federal health assistance programs aimed at at-risk families and children who need a long-term funding solution. In December, Congress passed a $2.85 billion "patch", meant to provide supplemental cash to the program as Congress continues to weigh plans for long-term funding.
When Marina Natali's younger son broke his arm ice-skating a year ago, she did not have to worry about paying: CHIP footed all of his medical bills.
Alabama and Utah are among the states unsure how long their federal CHIP funding will last, according to interviews with state officials.
In some states, children enrolled in CHIP would be protected by Medicaid provisions and the impact would instead be on the state budget, according to the report. Under the pool restrictions, states with excess dollars would have to give money to states running low.
Dr. Todd Wolynn, a Pittsburgh pediatrician, said families are reacting with "fear and disbelief" to CHIP's uncertain future. "They might not have a family physician, or a clear support system".
Last month's temporary budget fix, H.R. 1370, also provided $550 million for community health centers that serve more than 25 million, many in struggling communities - enough to last only through March 31. "We will have to decide between their health and spending the money on something else", she said.