CHIP has Proven Its Worth, It’s Time to Modernize it and Make it a Permanent Part of Children’s Health Coverage

Since its inception in 1997, the Children’s Health Insurance Program (CHIP) has established itself as a critical piece of the federal/state response to children’s health care needs and the historic reduction in children’s uninsured rates (which sadly started going in the wrong direction during the Trump Administration). In addition to covering over 6 million children directly, CHIP has spurred outreach and enrollment simplification efforts that have resulted in more eligible children receiving Medicaid.

Though children enrolled in separate CHIP programs do not have the same coverage guarantee as children in Medicaid, the coverage provided to children under CHIP is more comprehensive and responsive to their needs than benefits provided through federal and state marketplaces and likely more affordable than employer-sponsored insurance in most cases. While having health insurance is not enough to ensure that kids grow and thrive, it is the price of admission to our health care system.

Unlike Medicaid, CHIP has to be periodically renewed by Congress. Throughout most of its history, CHIP has had bipartisan support. Yet despite its popularity on both sides of the aisle, its extension has not always been a smooth process. Most recently, Congress let annual funding for CHIP lapse from September 30, 2017 until January 22, 2018—forcing states to rely on carryover funding and, in some cases, to notify families that the state was planning to close enrollment. This lack of financial certainty does not work well for states or families and deters states from making program improvements when they are uncertain about future funding.

In a new brief in our Future of Children’s Health Coverage series, Anne Dwyer and I examine CHIP and make recommendations on how to prevent lapses in funding in the future. We also make recommendations on how to modernize CHIP – which after all was initially established way before the Affordable Care Act was passed in 2014. Some provisions are relics of a pre ACA era – like waiting periods and lockouts – which force kids to be uninsured for a period of time. They have no place in a reformed health care system and must go.

We hope you will take time to read the full brief and share it with others who are working on behalf of America’s children. We welcome your thoughts and suggestions as we work together toward a day when all children and their families have access to high quality, affordable health care.

[Editor’s Note: You can find the child uninsured rate, CHIP/Medicaid eligibility threshold and policies impacting children’s health on CCF’s interactive state data hub.]

Joan Alker is the Executive Director of the Center for Children and Families and a Research Professor at the Georgetown McCourt School of Public Policy.