Last month, Congress let funding for the Children's Health Insurance Program (CHIP) expire, sending states that rely on that money scrambling to figure out how to pay for it. But CHIP wasn't the only casualty of congressional inaction on Sept. 30.
The lesser-known Maternal, Infant and Early Childhood Home Visiting Program (MIECHV), which is federally-funded but administered by states, also expired that day.
The program helps at-risk parents -- teen mothers and substance abusers, for example -- care for their children during their first years of life. Nurses and social workers provide them with pre- and postnatal care, parenting skills and counseling on education and job opportunities. It varies from state to state, but most participants receive home visits until their kids are two or three.
The federal government has funded the program for fiscal year 2018, but after that, it's uncertain. Without more federal funding, states may start freezing enrollment.
In Iowa, Janet Horras, home visitation director for the state's Department of Public Health, says she plans to freeze enrollment in January so that the families who are currently enrolled will receive services as long as possible.
A bill to revive the program through 2022, introduced by U.S. Republican Rep. Adrian Smith, passed the House in September, but there has been no action on it since then.
The program served 160,000 families in 2016, according to Health Resources and Services Administration. By comparison, CHIP serves 9 million low-income children and pregnant mothers who don’t qualify for Medicaid. While MIECHV is relatively small, advocates say it prevents the neediest families from falling through the social service cracks.
“This program is really built on continued involvement in the parent’s lives,” says Teri Weathers, director of federal policy and government affairs at Nurse-Family Partnership, one of the largest organizations that contracts with states to administer the program.
When a program like this runs out of money, there’s no longer a nurse checking up to see if a child is developing at the right stages or if a mom is getting her breastfeeding support, she says. “That’s the message we’re trying to drive home. This funding directly impacts families."
*CORRECTION: A previous version of this story referred to the Maternal, Infant and Early Childhood Home Visiting Program as the Mother, Infant and Early Childhood Home Visiting Program.