The Chicago Department of Public Health is once again vaccinating a group of low-income children who live outside the city, WBEZ has learned.

The move comes after Democratic Illinois Gov. JB Pritzker reversed a state policy last week that had made it harder for kids on the state-run Children’s Health Insurance Program, known as CHIP, to get immunized. The original policy, enacted under former Republican Gov. Bruce Rauner in 2016, forced doctors to pay up front for expensive vaccines. That prompted some health care providers – including the city of Chicago – to turn kids away because they couldn’t afford it.

The reversal came just in time. This fall, the city was planning to stop vaccinating all children with CHIP coverage – regardless of where they live – because of the cost, said Dr. Marielle Fricchione, medical director of the immunization program at the city’s public health department.

“We were going to hit a wall this back-to-school season if a change wasn’t made,” Fricchione said. “We tried to use that argument when we were trying to encourage this change to happen, is that this safety net was not sustainable. I think that helped convince people that this change had to be made immediately.”

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Chicago’s public health clinics became a go-to referral for many doctors, especially those in the collar counties such as Lake and DuPage, after they stopped vaccinating children on CHIP because of the Rauner administration’s 2016 policy shift.

Children can get health insurance through CHIP if their parents make too much money to qualify for Medicaid, but not enough to afford more expensive private insurance. There were about 130,000 kids in Illinois who had CHIP coverage in 2018.

Before the 2016 change, Illinois dipped into free vaccines from a federal program for kids enrolled in CHIP who can’t afford to pay for the expensive shots. But it turned out that children who have CHIP insurance weren’t eligible to be getting the free vaccines.

The federal government called for Illinois and other states to pay for the doses they erroneously used on CHIP kids. Illinois’ debt is about $24 million, and Pritkzer is working on paying it back.

To stop the IOU from climbing higher, Rauner in 2016 halted free vaccines for kids on CHIP. Instead, he required doctors to buy vaccines privately, then wait to get reimbursed by the state or by private insurers.

But many doctors told WBEZ that fronting money for vaccines was too expensive. So they stopped immunizing their patients with CHIP insurance and instead sent them to other clinics, including to those run by the Chicago public health department.

The city spent nearly $700,000 vaccinating kids on CHIP – both suburban and Chicago residents – since the 2016 policy change. About 30% of the kids came from the suburbs.

But eventually, the expense became too much for Chicago, too.

In June 2018, the city stopped vaccinating CHIP kids who trekked to the city for their shots. Part of that nearly $700,000 pot was earmarked for other purposes, including covering flu shots for Chicago residents, Fricchione said. The city’s public health department provides immunizations at more than 80 events every fall. The department wants to offer expensive, high-dose flu shots to seniors in particular because they’re among people who can get the sickest if they get the flu.

“We wouldn’t have been able to sustain both the CHIP vaccination program and our flu vaccination program starting this fall,” Fricchione said.

“So this was extremely good timing,” she said of Pritzker’s policy reversal on July 1.

Now, doctors in Illinois can again get free vaccines from the state, and the state will reimburse the federal government. The Chicago Department of Public Health won’t turn away any child with CHIP insurance.

Still, Fricchione said she doesn’t expect a rush of suburban kids insured by CHIP. That’s because their primary care doctors who no longer have to front money for vaccines will likely welcome those young patients back.

“That’s also the best part of this,” Fricchione said. “Children don’t have to make another stop. Parents don’t have to take off work to come to our walk-in clinic. They can see their doctor as usual and get this vaccine.”

Kristen Schorsch covers Cook County politics for WBEZ. Follow her @kschorsch.