Nearly 2 million children will lose health coverage starting next month if Congress doesn't renew funding for the Children's Health Insurance Program (CHIP) by Friday, a new report projects.
Already, state CHIP administrators say, parents are panicking and permanent damage has been done to the program, set up to take care of kids who don't have health insurance through other programs.
CHIP covers 9 million children across the country. Congress failed to authorize funding in September, and some states have already started warning parents to get their last medical visits in while money lasts.
"Our phones are ringing off the wall," said Cathy Caldwell, director of the Alabama Bureau of Children's Health Insurance.
"We have panicked families wondering what in the world they have as options. So it is just very, very stressful here in Alabama," Caldwell told reporters in a telephone briefing.
The crisis puzzles health policy experts, doctors and politicians, who say CHIP is a universally popular program that's never been made into a political pawn before.
Earlier Wednesday, Democrats in Congress urged their GOP colleagues who control both the House and Senate to act by Friday. "This is the ultimate bad Christmas carol story," Rep. Jackie Speier, D-Calif., said at a news conference where politicians held lumps of coal.
Related: Millions of kids stand to lose health insurance
CHIP has bipartisan support, but Republicans have beenfocused on passing a tax reform bill — their first legislative victory for 2017.
"Congress must get CHIP done before they leave for the holidays," said Joan Alker, executive director of the Georgetown University Research Center, which issued the latest report.
"Families need the peace of mind that their child's coverage will not disappear as the new year begins."
The report finds that 20 states will run short of money in the first quarter of 2018.
"There's no good options here."
"Never before has congress let CHIP funding lapse for this long a period of time," Alker said.
The continuing resolution that Congress passed earlier this month shifts around $1.24 billion in CHIP funds so that the states running out the fastest get some 2017 money. But that's at the expense of states that were not running out as quickly.
Related: Letters warn CHIP families they are about to lose out
"In essence, the patch robs Peter to pay Paul," the report reads.
"The remaining 31 states will see their share of redistribution funds reduced, and thus the timeline by which they will run out of money is accelerated. Despite the additional funds, the 20 'winner' states will only have sufficient funds to operate their programs through January," it adds.
"All of them will come up short for February."
Linda Nablo, chief deputy director of Virginia's Department of Medical Assistance Services, said her state has even less money than she thought just weeks ago.
"There's no good options here," Nablo said.
Related: Stopgap spending plan leaves out kids' health insurance
Caldwell said Alabama is already making contingency plans.
If Congress provides funding by Friday, the state will not have to freeze its programs.
"If it happens after Feb. 1 … then we're looking at rebuilding the program," Caldwell said.
"Even what's happened so far, I believe, will cause irreparable damage to the CHIP program. It's already negatively affecting our credibility."
The last time Alabama froze enrollment into CHIP, some families stayed away for a decade after funding was restored, she said.
"It will take us years and years to overcome it," Caldwell said. "But by far the worst is what's going to happen to the children who lose coverage."
Pediatricians say when kids don't have health insurance, their parents skip needed medical care.
"For some conditions, that can be deadly," said Dr. Sam Bartle, a pediatric emergency medicine physician at the Virginia Commonwealth University/VCU Health System and president of the Virginia chapter of the American Academy of Pediatrics.