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Notices ready to go warning of FAMIS cut-off / November 29, 2017
Hundreds of local families with children covered under Virginia’s FAMIS health insurance program can expect to receive notices in the coming week warning of a possible termination of coverage.

Virginia is one of nearly a dozen states that are planning to send out notices in response to Congressional inaction on reauthorizing the State Children’s Health Insurance Program (CHIP). Unless Congress resolves the issue this week — considered highly unlikely — Virginia will send out its notices to families on Friday, Dec. 1 warning that funds for the program may dry up.

Sandra Gregory, director of Mecklenburg County Department of Social Services, says she remains hopeful that Congress will act responsibly and reauthorize spending for the program before the December 31 deadline. She said she cannot say how many Mecklenburg families would be impacted if FAMIS ends because some, though not all families, might qualify for benefits under Medicaid for family and children, while others might receive Medicaid through TANEF, and still others through the Obamacare exchange at

“We are required to re-evaluate any case that has been closed,” said Gregory, which could happen if funding for FAMIS ends.

“It won’t look good for Congress if they fail to pass a bill that includes monies for the child health insurance program,” Gregory said, adding, “We are in a poverty zone and so this area will be hit hard.”

Already, county DSS staff is preparing for the onslaught of notices and potential case reviews that will be triggered should FAMIS money go away.

FAMIS, which stands for Family Access to Medical Insurance Security, is Virginia’s version of the state child health insurance program. Since being established in the 1990s, FAMIS has provided health insurance for children up to age 19 in families that earn too much to qualify for standard Medicaid. A variant of the program also insures pregnant women. The 2017 income cutoff for FAMIS beneficiaries is $50,430 for a family of four.

FAMIS is widely credited with reducing Virginia’s uninsurance rate for children to a record low of 4.5 percent. In an October letter to Virginia’s congressional delegation, Gov. Terry McAuliffe said loss of coverage “will have devastating impacts on the health and economic security of the families we serve.

“Please do not continue to ignore this crisis. States cannot wait until the last federal dollar is gone before initiating shut-down activities and informing families,” McAuliffe wrote.

Unless Congress acts, Virginia will freeze enrollment in the program on Jan. 1, and “by Jan. 31, Virginia will have insufficient federal funds to continue the program. The state will have no choice but to terminate coverage at the end of January,” McAuliffe said.

Kay Crane, CEO of Piedmont Access to Health Services (PATHS), said the consequences of shutting down FAMIS would resound widely across Southside Virginia, including at PATHS’s Boydton health center.

“At all five of our locations [from Martinsville to Boydton] over 1,000 children would be impacted by this decision. The failure of Congress to reauthorize CHIP would impact our ability to get reimbursed for services for FAMIS patients,” said Crane. “These are hardworking parents who do not qualify for Medicaid, yet cannot afford [private insurance] or their employer does not offer it.

Beyond the children seen at PATHS facilities, Crane said, “Across the 5th Congressional District, which includes Mecklenburg County, 6,102 children and pregnant women are covered under FAMIS.” The numbers she cited, she said came from Governor Terry McAuliffe’s office.

A different measure of the program’s reach is the number of recipients in the Southside Virginia region: 5,705 in 2017, according to the Department of Medical Assistance Services, which defines Southside Virginia as the 12-county region from Southampton to Franklin counties, extending north as far as Prince Edward and including the cities of Emporia, Danville and Martinsville.

PATHS is a non-profit organization whose mission is to provide healthcare to all citizens in South Central Virginia regardless of their ability to pay.

The future of the CHIP program is looming as a potential fight in December after Congress missed the deadline for reauthorization in August. Earlier this month, after the House passed legislation to extend funding for community health centers, 5th District Congressman Tom Garrett said, “Governor McAuliffe and all 171 Congressional Democrats who voted against this bill should know, today, I voted to extend the Children’s Health Insurance Program for five years.” He called the program an “important safety net that provides lower-come children access to high quality health care, and continues funding for our very successful and cost-effective community health centers.”

“Extending funding for our community health centers is especially important in the Fifth District. Ensuring access to healthcare in rural and underserved communities is a priority. I am pleased to know that these community health centers will remain open across the Fifth District and around Virginia.”

The bill that Garrett supported included provisions that would require older Americans with income of more than $500,000 a year to pay higher Medicare premiums, and make it easier for states to eliminate Medicaid coverage for some low-income people who hit the jackpot in lotteries. Both provisions were opposed by House Democrats. Under current Medicaid rules, income received as a lump sum, such as lottery winnings, is counted as income only in the month when it is received.

Resolving the impasse on CHIP funding is a top priority of Congressional Democrats, along with fixing DACA (the immigration policy for young immigrants known as Dreamers) and Obamacare. Congressional Democrats have threatened to withhold support for the federal budget if the Republican leadership in Congress refuses to bend on the programs. Democrats’ votes have been essential for enacting the budget, with the fractured Republican majority in Congress unable to muster the votes on its own to pass a budget plan.

The fluid political situation in Washington has given rise to speculation that reauthorization of CHIP — a routine matter in past years — could come as part of a wide-ranging deal on a number of hot-button issues. But Virginia officials say they cannot act on the basis of what might happen.

“We don’t want to act too fast if Congress is going to restore this, but we also want to give families enough time,” Linda Nablo, chief deputy director of the Department of Medical Assistance Services, told The Washington Post this week. “We have kids in the middle of cancer treatment, pregnant women in the middle of prenatal care.

“You can’t say ‘probably’ everything is going to be all right,” Nablo told The Post.

If Virginia is forced to end FAMIS, the state will look at how many children can be shifted to standard Medicaid, or else provide guidance to families on how they can purchase health insurance through Obamacare. McAuliffe estimated that 66,000 children could lose FAMIS coverage entirely, while 59,000 will be switched to Medicaid if CHIP funding is cut off.

Gregory called FAMIS “a good program,” and the thought of losing it causes her great stress. Particularly because, despite her role as head of a social service agency, she is powerless to impact decisions by Congress or even the actions of the federal government when it comes to FAMIS, which at the federal level is known CHIP

Governor McAuliffe warned that switching beneficiaries from FAMIS to Medicaid would come “at a cost of tens of millions of dollars annually to the state’s General Fund. Identifying resources to cover these costs will likely require cuts to other important functions of state government,” McAuliffe wrote to Congressional representatives.

Under the Children’s Health Insurance Program, the federal government funds 88 percent or more of the cost of health coverage for children. President Trump has proposed to cut billions from CHIP over two years, and Congress has deadlocked on paying the annual $15 billion budget for the program.

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When did the state become your nanny? This is a waste of money? Give up your cell phones etc and maybe you can pay your medical bills.



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