One million of those kids live in Texas.
"This is a really big deal," said Ryan Van Ramshorst, a pediatrician with University Health System. "These are kids from low-income families whose parents' work doesn't offer insurance, these are kids with special needs, these are kids with behavioral health problems."
Van Ramshorst said that 70 to 80 percent of UHS' patient population receives either Medicaid or CHIP funding. And at his pediatric clinic, he sees at least one CHIP recipient a day.
Without the federal funding, it will fall on the state's Health and Human Services Commission (an agency which is currently in "disarray") to fix the problem — or risk leaving one million kids uninsured.
CHIP funds are expected to cease at the end of October, but Texas will be able to stretch its funding until 2018, according to Joyce Mauk, medical director of the Texas Pediatric Society. Some states, however, may run out by the end of November.
CHIP has received bipartisan support since its 1997 start — an unusual feat for health care policy. But, neither the U.S. House or Senate brought up a vote to reauthorize CHIP before the weekend deadline. Mauk said she's "fervently hopeful" that last-minute hearings in Congress will help reinstate the funds before states run out.
"But in the meantime," she said, "It's more pressure on families who may rely on CHIP coverage and pressure on clinics who don't know whether they'll be reimbursed for a visit or not."
Mauk cited studies proving that kids with health insurance "do better overall" as they age — whether that's measured in hospitalizations, success in school, or long-term health.
"It acts like a safety net for parents who can't get insurance through work," Mauk said. "It's so beneficial. The decision to end it would be incredibly short-sighted."
Without CHIP, Van Romshorst said it would be "very, very difficult" for the families of CHIP recipients to afford other insurance coverage for their kids. For many, he said, just the cost of a co-pay alone would be a third of a family's monthly income.
"That will mean kids with asthma would go without their medication, or kids with behavioral issues will go without ADHD therapy," Van Romshorst said. "That's huge."