Children's Health: About CHIP
Eligibility | Financing
The state Children’s Health Insurance Program (CHIP) was created in 1997 to provide health coverage to low-income children in families that earn too much to qualify for Medicaid but not enough to afford private insurance. Like Medicaid, CHIP is a state-federal partnership. All states have a CHIP program, and they have considerable freedom in how they design their programs. They can be simple expansions of the Medicaid coverage already available to children in the state, an entirely separate program, or some combination of these. States’ programs vary on a wide range of elements, including eligibility levels, whether or not to charge cost-sharing or premiums, and how the enrollment process works.
The program provides health coverage to more than 7 million children and is an essential part of the nation's health care safety net. After 10 successful years, during which the number of uninsured children dropped by nearly a third, the program was due to be reauthorized in 2007. Although Congress twice passed bipartisan legislation that would have reauthorized the program until 2012, the President vetoed both bills. The program was ultimately reauthorized in February 2009. See CHIPRA Implementation for more information.
Most states provide coverage for uninsured children with family incomes up to two times the federal poverty level. However, a few states have set higher income limits, and a few states have lower income limits. New York, for example, covers uninsured children with family incomes up to 400 percent of poverty (an annual income of $73,240 for a family of three in 2010). At the other end of the spectrum, North Dakota covers uninsured children with family incomes up to 160 percent of poverty (an annual income of $29,300 for a family of three in 2010).
Medicaid and State Children's Health Insurance Program (CHIP) Eligibility by State (May 2010)
Children Enrolled in Medicaid and the State Children's Health Insurance Program (CHIP) (July 2008)
SCHIP 101: What Is the State Children's Health Insurance Program, and How Does It Work? explains the basics about SCHIP, including who qualifies for SCHIP, how SCHIP is financed, and whether eligible children are getting enrolled. (November 2006, updated June 2007)
SCHIP and Children's Health Coverage: Fitting the Pieces Together examines where children, including low-income children, get their health coverage, as well as how SCHIP and Medicaid have reduced the number of uninsured children. (November 2006, updated June 2007)
SCHIP and Children's Health Coverage: Leveling the Playing Field for Minority Children examines the important role that SCHIP plays in reducing disparities in access to care, as well as how the SCHIP reauthorization process can be used to further this effort. (December 2006, updated June 2007)
Screening for Medicaid and State Children's Health Program (SCHIP) Eligibility is intended as a reference to help determine whether someone may qualify for Medicaid or SCHIP coverage. Each question includes federal and state-specific information. (2004, updated 2007)
When One Size Doesn't Fit All: the Importance of State Flexibility in SCHIP Eligibility looks at how different costs of living in different parts of the country affect how far a dollar goes, and how this relates to state choices to set SCHIP eligibility limits higher than twice the federal poverty level. (April 2007)
Congress originally allotted a total of $40 billion over 10 years for CHIP, starting in fiscal year 1998. A complex formula that included the number of low-income children; the number of low-income, uninsured children; and annual wages in the state's health care industry was used to determine each state's allotment. States had three years to use their allotments from any single fiscal year. There was also a mechanism for reallocating unspent CHIP money from states that didn't use their full allotments to states that did use all of their allotments and needed extra CHIP funds.
When the program was reauthorized, the formula for allocating funding to states was changed significantly. See More Funding for CHIP, Different Rules for details.
Federal Matching Rate (FMAP) for Medicaid and the State Children's Health Insurance Program (CHIP) (March 2010)