When September ends, Congress will reclaim more than $1 billion in child health insurance money from 37 states that didn't use it in time - about $18 million of it from Nevada.
The program was created in 1998 and, in Nevada, funds the Nevada Check Up program which provides comprehensive health coverage to children in families that make too much to qualify for welfare but not enough to buy health coverage.
The catch is any money not used in three years goes away.
John Yacenda, chief of Nevada Check Up, said the reason Nevada didn't use up the more than $30 million available to it in 1998 was that it took most of that year to create and start the program.
"The only thing Nevada was doing during federal fiscal year 1998 was putting out applications, accepting applications and getting ready to begin enrollment," he said. "There was no service delivery program in federal fiscal 1998."
Now, however, he says the program is up and running with about 12,000 children enrolled and receiving benefits that include health coverage, dental and vision care.
Yacenda said the federal government will get back some of Nevada's allotted funding next year as well because the enrollment was still small in 1999.
"We anticipate that less and less money will be returned in each subsequent year," he said. "We're having enrollment increases now because the program is starting to take hold. People are happy with it and they're telling friends, co-workers and neighbors."
Most of the other states on the list will surrender far more money than Nevada.
California will give up some $592 million and Texas more than $443 million in 1998 funding for the program.
Each state's grant was based on census estimates of how many uninsured children live in that state.
But to make sure states got programs going that would help children, Congress won't allow the cash to be hoarded. Anything not used for three years is taken back by the federal government. Since the law was passed in 1998, the first year's money will be reclaimed by the federal government at the end of September.
The original legislation said that money would be redistributed among the states that used all their grant money - which would be a huge windfall for the 13 states in the South and on the East Coast which did so.
But there have been several other suggestions including a provision in the Senate version of the 2001 health care budget that would rescind the surplus. That would let Congress spend the money anywhere else.
Another suggestion, he said, was to turn the money back to the states for special, one-time projects and enhancements for low-income children. He said those grants would be awarded based on need.
But he said the option he favors is to return the money to the states and keep it in the program.
"We favor keeping the money in the program and giving the states more flexibility in using it," he said.
Yacenda said the flexibility they need most is in marketing the program to get word of what it does and how much it can help lower-income people provide coverage for their children.
If they can do that, he said, he expects the program to grow to more than 21,000 children by the end of next fiscal year.