About SCHIP
Cost Sharing
States may impose cost- sharing (i.e., deductibles, coinsurance, and co-payments) for some children enrolled in SCHIP, within federal guidelines. In general, states cannot adopt cost sharing or premium policies that impose costs that exceed five percent of family income or that favor higher-income families over lower-income families. They also are prohibited from imposing cost-sharing for well-baby and well-child care, including immunizations. Finally, states cannot count money raised through premiums or cost sharing as state dollars for purposes of meeting the block grant's matching requirements.
For more information see: The Deficit Reduction Act: A Review of Key Medicaid Provisions Affecting Children and Families.
Research has shown that premiums in Medicaid and SCHIP depress enrollment because of the financial burden they impose on families, potentially increasing the number of uninsured children. For more information see:
- Increasing Premiums and Cost Sharing in Medicaid and SCHIP: Recent State Experiences, Kaiser Commission on Medicaid and the Uninsured (May 2005).
- The Effect of Increased Cost Sharing in Medicaid: A Summary of Research Findings, Center on Budget and Policy Priorities (July 7, 2005).