Fourteen of the 24 states with a separate CHIP program, like Iowa’s hawk-i, have said they plan to terminate or phase out CHIP coverage for children; eight have said they will do so by the end of February, according to Kaiser.

Seven states said they plan to freeze CHIP enrollment, and at least three have announced plans to move separate CHIP enrollees into Medicaid, according to Kaiser.

In these states, as in Iowa, state officials find themselves largely at the mercy of the federal government.

One Iowa official is calling for “swift, firm, united action.”

“This crisis affects families in every county of this state. This is an all hands on deck moment for Iowa’s elected leaders,” Nate Boulton, a state senator from Des Moines, hawk-i board member, and Democratic candidate for governor, said after the board’s meeting this past week.

Boulton said the Iowa Legislature should, once it convenes in January, approve a resolution requesting Congress fully fund CHIP, and that Iowa Gov. Kim Reynolds should travel to the nation’s capital to make the case in person to Congress and the president.

“We need swift, firm, united action to prevent a children’s health care crisis in Iowa,” Boulton said.