The Future of the Children’s Health Insurance Program

Later this year, we’re likely to see a battle in Congress over the renewal of the State Children’s Health Insurance Program, what’s commonly referred to as the CHIP program.

Similar to Medicaid, CHIP is financed by both the federal government and the states, offering health coverage for children from low-income families and pregnant women. In 2013, the program enrolled 8.4 million and by most accounts has worked as planned.

Between 1997—the year Congress first authorized CHIP–and 2012, uninsured rates among uninsured children dropped from 25 percent to 13 percent despite the deep economic recession. Over the same period, CHIP’s coverage rates rose from 41 percent to 63 percent. CHIP, which is a means-tested program, increased access to health care and has been shown to reduce the financial burdens and stress on families associated with meeting children’s health care needs.

CHIP was last reauthorized by the Affordable Care Act (ACA) through fiscal year 2019, but the law only provided funding for the program through September 30, 2015.

The fiscal year 2016 budget President Obama sent Congress on February 2 includes an additional four years of funding for CHIP through 2019 to align with the program’s maintenance of effort requirement and ensure comprehensive and affordable coverage for children covered by CHIP. This extension will provide stability to state budgets and continuity of coverage to families that rely on CHIP. The president’s proposal is paid for through an increase in tobacco taxes.

CHIP has historically enjoyed bipartisan support in Congress despite its share of early implementation problems, not unlike those experienced by the healthcare.gov website. Those early obstacles slowed initial enrollments until policymakers got serious about fixing them. But the ACA has stirred the political landscape significantly.

The new 114th Congress will likely continue long-running battles over ACA policies and spending requirements. While the divisive politics dominating the public conversation about ACA threaten to get in the way again the fact remains, the uninsured rate among children dropped again last year, even as the child poverty rate remained high, due overwhelmingly to CHIP and Medicaid, which protected kids from becoming uninsured in the wake of a recession that cost millions of families their employer-sponsored coverage.

CHIP and Medicaid, not ACA, are the keys to covering most of the 6.3 million children who remain uninsured.

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