State Children’s Health Insurance Program (SCHIP)
Excerpted from the Congressional Research Service RL30473
Updated November 14, 2007
Elicia J. Herz, Chris L. Peterson, and Evelyne P. Baumrucker
Domestic Social Policy Division
Read the pdf.
The Balanced Budget Act of 1997 (BBA 97; P.L. 105-33) established the State Children’s Health Insurance Program (SCHIP) under a new Title XXI of the Social Security Act. In general, this program allows states to cover targeted low-income children with no health insurance in families with income that is above Medicaid eligibility levels. The highest upper income eligibility limit for children in SCHIP is 350% of the federal poverty level, in one state, New Jersey.
Under SCHIP, states may enroll targeted low-income children in an SCHIPfinanced expansion of Medicaid, create a new separate state SCHIP program, or devise a combination of both approaches. States choosing the Medicaid option must provide all Medicaid mandatory benefits and all optional services covered under the state plan, and must follow the nominal Medicaid cost-sharing rules. In general, separate state programs must follow certain coverage and benefit options outlined in SCHIP law. While some cost-sharing provisions vary by family income, the total annual aggregate cost-sharing (including premiums, copayments, and other similar charges) for a family may not exceed 5% of total income in a year. Preventive services are exempt from cost-sharing.
Nearly $40 billion was appropriated for SCHIP for FY1998 through FY2007 in BBA 97. Annual allotments among the states are determined by a formula that is based on a combination of the number of low-income children and low-income uninsured children in the state, adjusted by a cost factor that reflects the average health service industry wages in the state compared to the national average. A continuing resolution (P.L. 110-92) was enacted to provide FY2008 SCHIP allotments through November 16, 2007. A second continuing resolution was enacted (P.L. 110-116) to extend the FY2008 allotments through December 14. All states, the District of Columbia, and five territories have SCHIP programs. The territories, the District of Columbia, and 8 states use Medicaid expansions; 18 states use separate state programs; and 24 states use a combination approach. At the national level, approximately 6.7 million children were enrolled in SCHIP during FY2006 (latest official data). In addition, 12 states reported enrolling about 701,000 adults in SCHIP through program waivers.
Spending was slow in the early years of SCHIP, but that trend changed in more recent years and led some states to exhaust their federal SCHIP funds. Congress appropriated additional SCHIP funds to address states’ shortfalls in FY2006 ($283 million) and FY2007 ($650 million). Congress passed two bills that would “reauthorize” SCHIP — providing SCHIP funding through FY2012 and making other changes to both SCHIP and Medicaid. H.R. 976 was vetoed by the President, with the Congress unable to override the veto. H.R. 3963 is expected to be vetoed by the President, as well.
Pages: 1 2
Edit this PageWIKI:
Our issue pages are taken from Congressional Research Service reports to guarantee objectivity and accuracy. You can help us by expanding the discussion on this issue.
[edit] Action in Congress
President Obama signed the S-CHIP reauthorization on February 4, 2009. In January 2009, Democrats worked to push through a bill to increase funding for the SCHIP program so that President-elect Obama can pass it in his first days in office. They hope that the bill will be more successful in the new administration than it was with President Bush, who vetoed it during his term. [1]
[edit] Endnotes
- ↑ Sean Lengell. "Democrats set vote to tighten health gap." Washington Times. January 12, 2009. http://washingtontimes.com/news/2009/jan/12/democrats-set-vote-to-expand-kids-health-plan/
