Congress is on the verge of leaving town for the weekend without extending the Children’s Health Insurance Program, which expires Saturday. The move could put a financial strain on states—and eventually jeopardize coverage for the roughly 9 million children covered by the program.

And it’s not good news for district leaders and the children they serve, said Sasha Pudelski, the co-chair of the Save Medicaid in Schools Coalition.

“We desperately want to make sure that kids are coming with health care, ready to learn,” said Pudelski, who is also the assistant director of policy and advocacy for AASA, the School Superintendents Association.

What’s more, some schools could take a financial hit if the program isn’t renewed soon.

CHIP, which was created in 1997 with bipartisan support, is aimed at children whose families make too much money for Medicaid—the state and federal program for the poor—and who aren’t afforded health care through their employers, or can’t cover the cost of insurance on the individual market.

Fourteen states and the District of Columbia treat their CHIP dollars the same way they treat their money from another federal program, Medicaid. Schools in those states—which include some big population centers like California and Michigan—are reimbursed by both Medicaid and CHIP for things like speech therapy, mental health, hearing and vision screenings, and other services, Pudelski said.

Schools receive about $4 billion a year from Medicaid, but it’s tough to say just how much they get from CHIP on top of that, Pudelski said. She expects that schools could miss out on funding, or be delayed in receiving it, if the program isn’t renewed soon.

And if kids show up to school in need of health services to enable them to learn—like hearing aid or glasses to see the blackboard—districts might decide to use their own resources to help.

“If a kid comes in and can’t see and can’t hear and we have someone in house who can help them, we have to divert resources to take care of their health needs,” Pudelski said.

And she’s warning school superintendents to be prepared to deal with parents’ questions about how they can fill in gaps in their child’s coverage, if the program does expire and states aren’t able to step in.

CHIP was last renewed in 2015 with no significant changes. Lawmakers typically renew it far ahead of the deadline, said Elisabeth Burak, the senior program director the Center for Children and Families at Georgetown University.

The delay means a lot of unnecessary stress” on families and state leaders alike,” she said. Renewing the program quickly “should be a no brainer.”

It’s not clear, though, when Congress will act. Sens. Orrin Hatch, R-Utah, and Ron Wyden, R-Oregon, have put introduced a bill in the Senate to keep the program up and running. And over in the House, Rep. Pete Sessions, R-Texas, said Wednesday that the need to extend isn’t “dire or urgent.” He argued that states have enough money left in their coffers to keep them going until the end of the year.

But Burak pointed out that Minnesota has already sent a letter to its congressional delegation saying that the state would have to take “extraordinary measures” and may have to spend $10 million of its own money to make sure health services are extended. The National Governors Association has also asked Congress to extend CHIP.

Joan Alker, the executive director of the Center for Children and Families, tweeted that Utah may be running into trouble too.

Breaking news I hear that Utah (!) is now the first state that has submitted request to feds to start process to freeze kids CHIP enrollment

— Joan Alker (@JoanAlker1) September 28, 2017

Plus, the uncertainty itself is a problem. States need to plan their CHIP expenditures, which is tough to do if they’re not sure the program is sticking around, Burak said. What’s more, if states need to tap some of their own money to make up for a loss in CHIP funding—even a temporary one—K-12 spending could be squeezed.

“This could have a domino effect for kids, and families, and communities and schools,” Burak said.

Pudelski, for one, is worried that the renewal of CHIP, a health care program, could get tangled up in the bigger political fights over things like the Affordable Care Act or even the fight over funding for Planned Parenthood.

“It’s really telling of the political environment we’re in,” she said. “Something that has not been a political football in the past could potentially become one.”

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