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Childrens Health Insurance Program Overview

Children's Health Insurance Program Overview

8/1/2011

ChildrenThe Children's Health Insurance Program (CHIP, formerly the State Children's Health Insurance Program (SCHIP)) was created by the Balanced Budget Act of 1997, enacted Title XXI of the Social Security Act. It has allocated about $20 billion over 10 years to help states insure low-income children who are ineligible for Medicaid but cannot afford private insurance.

States receive an enhanced federal match (greater than the state's Medicaid match) to provide for this coverage. In 2007, after President Bush and Congress could not agree on CHIP reauthorization details, the program was extended through March 2009. In February 2009, the Children's Health Insurance Program Reauthorization Act of 2009 was approved by Congress and signed by President Obama.

In concert with the signing, President Obama sent a memorandum to the Centers for Medicare and Medicaid Services (CMS) requesting that they immediately withdraw the Aug. 17, 2007 Directive sent to state health officials that imposed conditions on states and limited their options to provide coverage to uninsured children. He requested that they implement CHIP from this time forward without these requirements.

Federal Health Reform and CHIP

President Obama signed the Patient Protection and Affordable Care Act, H.R. 3590, on March 23 and the Reconciliation Act of 2010, H.R. 4872, on March 30, 2010. (See the combined full text of Public Laws 111-148 and 111-152 here.)  Among many provisions, the laws extend the authorization of the federal CHIP program for an additional two years, through Sept. 30, 2015. The laws require states, upon enactment, to maintain current income eligibility levels for CHIP through Sept. 30, 2019. States are prohibited from implementing eligibility standards, methodologies or procedures that are more restrictive than those in place as of March 23, 2010, with the exception of waiting lists for enrolling children in CHIP. 

Additional provisions in the health reform package related to CHIP are summarized in the following resources:

NCSL Federal Health Reform Resources

Additional Federal Health Reform and CHIP Resources

Summary of Medicaid, CHIP and Low-Income Provisions in Health Care Reform
Center for Children and Families, Georgetown University Health Policy Institute, April 2010

Holding the Line on Medicaid and CHIP: Key Questions and Answers About Health Care Reform's Maintenance-of-Effort Requirements
Center for Children and Families, Georgetown University Health Policy Institute, March 26, 2010

NCSL CHIP Resources

Covering Kids
This State Legislatures magazine article focuses on outreach and enrollment efforts in the states to cover kids.
National Conference of State Legislatures, June 2009

Express Lanes, Premium Assistance and Contingency Funds: The New Provisions in CHIPRA
State Health Notes, National Conference of State Legislatures, June 22, 2009

CHIP Gets Renewed
State Legislatures magazine, National Conference of State Legislatures, April 2009

Children's Health Reform Laws
National Conference of State Legislatures webpage

News and Additional CHIP Resources

Two Year Anniversary of Children's Health Insurance Law Sees Millions of Newly Insured Children, Families
U.S. Department of Health and Human Services, Press Release, February 3, 2011

$10 Million in Grants Aimed at Enrolling American Indiana, Alaska Native Kids in Health Care to be Awarded
U.S. Department of Health and Human Services, Press Release, November 19, 2009

Secretary Sebelius Awards $40 Million to States to Find, Enroll Children in CHIP, Medicaid
U.S. Department of Health and Human Services, Press Release, September 30, 2009

HHS Secretary Sebelius Announces Availability of $40 Million in Grants to Help Insure More Children
U.S. Department of Health and Human Services, Press Release, July 6, 2009
Additional information:  Grants.gov

HHS Secretary Sebelius Announces Release of $6 Billion in New CHIP Funds to Insure Children
U.S. Department of Health and Human Services, Press Release, June 19, 2009

CHIPRA Guidance, Centers for Medicare and Medicaid Services

Letter to State Medicaid Directors Regarding ARRA Protections for Indians in Medicaid and CHIP
Centers for Medicare and Medicaid Services, January 22, 2010

Letter to State Health Officials Regarding H1N1 and Medicaid and CHIP
Centers for Medicare and Medicaid Services, September 24, 2009

CHIP Tips
A series of implementation briefs called “CHIP Tips” examines new opportunities for covering children following the reauthorization and expansion of CHIP.
The Kaiser Commission on Medicaid and the Uninsured

Summary of new CHIP Reauthorization Law
Center for Children and Families, Georgetown University Health Policy Institute, February 2009

Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA)
The Kaiser Commission on Medicaid and the Uninsured, February 2009

Children's Health Insurance Program Reauthorization Act of 2009, Public Law 111-3

CHIPRA Implementation Series: Exploring New Opportunities for Children's Coverage
Families USA

What Has Been Learned About Expanding Children's Health Insurance? Highlights from the Child Health Insurance Research Initiative (CHIRI), September 2009
The CHIRI project is funded by the Agency for Healthcare Research and Quality, The David and Lucile Packard Foundation, and the Health Resources and Services Administration.

Children’s Health Care Quality: Activities Related to CHIPRA
Agency for Healthcare Research and Quality

NOTE: NCSL provides links to other websites for information purposes only. Providing these links does not necessarily indicate NCSL's support or endorsement of the site.

This site is made possible by project, UC4MC21528, from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, U.S. Department of Health and Human Services.

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