Next steps for the Children’s Health Insurance Program
- Collection:
- Health Policy and Services Research
- Author(s):
- Alker, Joan, author Dwyer, Anne, author
- Contributor(s):
- Georgetown University. Center for Children and Families. issuing body.
- Publication:
- Washington, DC : Georgetown University Health Policy Institute, Center for Children and Families, August 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Child Health Financial Management Medicaid United States State Children's Health Insurance Program (U.S.)
- Genre(s):
- Technical Report
- Abstract:
- The Children’s Health Insurance Program (CHIP) serves a vital role in America’s health care system. First enacted in 1997, today CHIP provides health coverage to 6.8 million people each month—mostly children. Under the program, states are provided funding through a complex formula to cover children and pregnant individuals whose family incomes are over eligibility levels for Medicaid but may otherwise be uninsured. At present, the median income eligibility level for CHIP is 255 percent of the federal poverty line. Under the program, states can choose whether to accept funding and provide coverage to children through their Medicaid program or by establishing a separate CHIP program, or a combination of both. Most states operate combination programs with some individuals enrolled through the state’s Medicaid program and some enrolled in a separate CHIP program, or full Medicaid expansion CHIP programs (see map). As a result, the majority of children are now enrolled in CHIP-funded Medicaid programs. Only two states operate fully separate CHIP programs. In all states, CHIP sits on the shoulders of Medicaid—which covers a much larger number of children, nearly 32 million. Over the past several decades, Medicaid and CHIP together have contributed to a dramatic decline in the share of uninsured children of more than 60 percent —though the number of uninsured children began to increase from 2017 onward. As part of its financing structure, CHIP provides enhanced federal funding under which states receive federal matching funds for all children eligible for CHIP (even if they are covered through their Medicaid program) based on Medicaid’s formula, but with a higher level of federal participation than for Medicaid. Federal matching funds for CHIP were also further temporarily increased in response to the COVID-19 public health emergency as a result of the increase to the base Medicaid matching rate. See Appendix 1. However, unlike Medicaid, federal CHIP funding is capped and not permanent. As a consequence, Congress has had to act to reappropriate funds periodically. Currently, CHIP funding is available until September 30, 2027 (i.e., through federal fiscal year 2027), and states are also required to keep current income eligibility levels for children in place up to 300 percent of the federal poverty line through fiscal year 2027. While there is considerable bipartisan support for CHIP, its extension has not always been a smooth process in Congress. Most recently Congress let annual funding for CHIP lapse from Combination (33 states) Medicaid expansion CHIP (17 states including DC) Separate CHIP (2 states) States can choose whether to accept funding and provide coverage to children through their Medicaid program or by establishing a separate CHIP program, or a combination of both. September 30, 2017 until January 22, 2018—forcing states to rely on carryover funding and, in some cases, to notify families that they were planning to close enrollment. This financial uncertainty does not work well for states or families, and deters states from making program improvements when they are uncertain about future federal funding.
- Copyright:
- Reproduced with permission of the copyright holder. Further use of the material is subject to CC BY license. (More information)
- Extent:
- 1 online resource (1 PDF file (11 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918334381206676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918334381206676