CMS. Medicaid’s Milestones.
This webpage provides a list of Medicaid’s milestones, which includes the launch of SCHIP in 1997.
Congressional Research Service.
- Grady, A., et al. Medicaid, SCHIP, and Health Insurance: FY2008 Budget Issues. August 7, 2007. CRS Report for Congress. This report provides background information, a description of each of the President’s Medicaid and SCHIP proposals, and a list of relevant CRS reports.
State Children's Health Insurance Program (CHIP): A Brief Overview. Congressional Research Service. R40444. March 18, 2009 This report provides a history and overview of the State Children's Health Insurance Program (CHIP) including its 2009 reauthorization. It outlines coverage, eligibility, and financing of the program, and differences among states.
Dubay, L., I. Hill, and G. Kenney. Five Things Everyone Should Know about SCHIP. Oct. 2002. Urban Institute New Federalism A-55.
This brief discusses five key points about SCHIP – state flexibility, financing, effect on uninsurance rates, take-up rates, and recommendations for improvement.
Families USA, Children’s Health.
This page provides information on children’s health legislation, including the reauthorization of CHIP, and other related topics. Newest reports include:
- CHIPRA 101: Overview of the CHIP Reauthorization Legislation (March 2009).
- Getting Covered: Finding Health Insurance When you Lose Your Job (February 2009).
- Summary of Final CHIP Reauthorization Bill (February 2009).
Holahan, J., B. Garrett, I. Headen, and A. Lucas. Health Reform: The Cost of Failure. May 21, 2009
This report uses the Health Insurance Policy Simulation Model (HIPSM) to quantify the intermediate and longer-term implications if America’s health care system is not significantly overhauled. Under a range of economic scenarios, the analysis shows an increasing strain on business owners and their employees over the next decade if reform is not enacted. There would be a dramatic decline in the number of people insured through employers, and millions more could become uninsured. There would be large growth in Medicaid/CHIP enrollment and spending, and increased spending on uncompensated health care. Middle-income working families would be the most affected.
Kaiser Commission on Medicaid and the Uninsured.
The Commission provides information and analysis on health care coverage and access for the low-income population, with a special focus on Medicaid's role and coverage of the uninsured. Key reports include:
Oberlander, J. and B. Lyons. Beyond Incrementalism? SCHIP and the Politics of Health Reform. Health Affairs 28, no. 3 (2009) Published online 17 March 2009.
This article examines the political and legislative history of the Children’s Health Insurance Program and analyzes the lessons for policymakers who are contemplating broader health care reform.
Ryan, J. The Childen’s Health Insurance Program (CHIP): The Fundamentals. Background Paper — April 23, 2009.
This background paper provides a brief overview of the fundamental elements of the Children’s Health Insurance Program (CHIP). It provides a brief discussion of the rules around eligibility, benefits, and financing. It also outlines the new sources of funding that are available for reaching out to children who might be eligible for CHIP or Medicaid but have not enrolled, and for establishing quality and performance measurement standards for the program.
Rosenbach, M. et al. National Evaluation of the State Children’s Health Insurance Program: A Decade of Expanding Coverage and Improving Access. Mathematica Policy Research, Inc. submitted to Centers for Medicare & Medicaid Services. September 2007.
This report presents findings from the congressionally mandated evaluation of SCHIP, which was conducted by Mathematica Policy Research, Inc. through a contract with CMS. The evaluation contained a report to congress as well as analyses of SCHIP enrollment, trends in rates of uninsured, retention, access, outreach, enrollment, implementation, and performance measures.
Zuckerman, S. and A. Cook. “The Role of Medicaid and SCHIP as an Insurance Safety Net.” August 2006. The Urban Institute.
This data brief explores how well Medicaid and SCHIP protected health insurance coverage for low-income children as compared to low-income adults from the decline in employer-sponsored insurance between 2000 and 2004.
Avoiding Crowd Out: Policy Implications for Expanding Children’s Coverage. Policy Brief. Office March 2009.
This brief answers frequently asked questions on the problem of crowd-out in the health insurance market including strategies to avoid crowd-out and individual states’ concerns.
Blewett, L. A., M. Davern, and H. Rodin. 2005. “Covering Kids: Variation in Health Insurance Coverage Trends by State, 1996-2002.” Health Affairs 13(6): 170-180.
The authors of this article provide an overview of state outreach and administrative simplification efforts and raise questions about the persistent variation in children's health insurance coverage across states.
Buchmueller, T., A. Sasso, K. Wong. How Did SCHIP Affect the Insurance Coverage of Immigrant Children? Berkeley Electronic Journal of Economic Analysis and Policy . January 7, 2008.
In this article, the authors compare the effect of SCHIP eligibility on the insurance coverage of children of foreign-born and native-born parents to compare take-up rates between these groups.
Guendalman, S., M. Wier, V. Angulo, et al. February 2006. The Effects of Child-Only Insurance Coverage on HealthCare Access and Use: Recent Findings Among Low-Income Children in California. Health Services Research 41(1): 125-147.
This paper compares the extent to which child-only and family coverage facilitate health care access and use for low-income children in CA and discusses the policy implications of extending SCHIP to uninsured parents.
Kenney, G. And J. Plelletier. Setting Income Thresholds in Medicaid/SCHIP: Which Children Should Be Eligible? Timely Analysis of Immediate Health Policy Issues. January 2009. The Robert Woods Johnson Foundation and Urban Institute.
This paper explores important policy questions regarding CHIP, such as where eligibility thresholds should be set for public coverage and how much latitude states should have in setting these thresholds.
Ku, L. “Crowd-Out” Is Not the Same as Voluntarily Dropping Private Health Insurance for Public Program Coverage. Center on Budget Policy and Priorities. September 2007.
This report explores the problem of crowd-out in public health insurance programs, using data from the Congressional Budget Office.
Lee, H., et al. The State Children's Health Insurance Program: Participation and Substitution. August 2008.
The authors examine the effects of SCHIP enactment by focusing on two policy concerns: take-up and crowd-out. They analyze how changes in several SCHIP factors affected decisions regarding health insurance coverage.
Mathematica Policy Research, Inc., Covering Low-Income Children Through SCHIP and Medicaid.
This organization’s publications from SCHIP-related studies discuss issues related to access, enrollment, program evaluation, and state-specific experiences.
National Immigration Law Center. New State Option to Provide Health Coverage to Immigrant Children and Pregnant Women. April 2009.
This fact sheet highlights the key elements of the reauthorization law regarding coverage of immigrants.
Oral Health Coverage and Care For Low-Income Children: The Role of Medicaid and CHIP. Kaiser Commission on Medicaid and the Uninsured. April 2009.
This policy brief provides an overview of oral health care access and coverage for low-income children. It discusses dental coverage under the CHIPRA, as well as potential barriers that could leave many children without adequate oral health and dental care remain.
Robert Wood Johnson Foundation, Covering Kids and Family.
Covering Kids and Family is a national health access initiative for low-income uninsured children and adults. This website provides information on the state of national children’s health insurance programs and recommendations for improvement.
Robert Wood Johnson Foundation, Cover the Uninsured.
This website provides fact sheets about SCHIP and uninsured children. The policy section provides information about proposed national healthcare policies under consideration through charts and side-by-side comparisons.
Shore-Sheppard, L. Stemming the Tide? The Effect of Expanding Medicaid Eligibility On Health Insurance Coverage. Berkeley Electronic Journal of Economic Analysis and Policy, Advances article. July 19, 2008.
In this paper, the author reexamines the impact of Medicaid expansions on Medicaid take-up and private insurance “crowd-out” by investigating a number of critiques leveled at the seminal work of Cutler and Gruber (1996) and extending the analysis to include further expansions of Medicaid.
Enrollment and Administrative Procedures
Kaiser Commission on Medicaid and the Uninsured and Georgetown Center for Children and Families:
These briefs examine issues related to the new federal "performance bonus" available to states that do an especially good job of signing up eligible children for Medicaid. The bonus, created by a provision in the Children's Health Insurance Program Reauthorization Act of 2009, is designed to help states cover the added costs that result when states are very successful in enrolling eligible children in Medicaid above target levels specified in the law.
Dorn, S. Express Lane Eligibility and Beyond: How Automated Enrollment Can Help Eligible Children Receive Medicaid and CHIP (Research Report). Urban Institute. April 21, 2009.
Automated enrollment strategies have achieved remarkable results with many public and private benefit programs, dramatically increasing program participation while lowering administrative costs and reducing erroneous eligibility determinations. The recently passed Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) should make such steps much easier for states to take in covering eligible but uninsured children. Following CHIPRA's enactment, states have both new tools and new incentives to use automated strategies in fulfilling four key functions: identifying uninsured children; determining their eligibility for health coverage; enrolling eligible children into coverage; and retaining eligible children.
Dorn, S. B. Garrett, C. Perry, L. Cleamans-Cope, A. Lucas. Nine in Ten: Using the Tax System to Enroll Eligible, Uninsured Children into Medicaid and SCHIP (Research Report).Urban Institute. February 01, 2009
In 2004, 89.4 percent of uninsured children who qualified for Medicaid or the State Children's Health Insurance Program lived in families who filed federal income tax forms. This substantially exceeds the proportion of uninsured but eligible children who can be reached through many other outreach strategies. Federal lawmakers could cover uninsured children in these families by: (a) changing federal income tax forms so parents can identify their uninsured children and request coverage; (b) investing in information technology allowing data exchange between states and the Internal Revenue Service; and (c) letting states cover uninsured children if tax information shows they qualify.
Kaiser Commission on Medicaid and the Uninsured, Enrolling Uninsured Low-Income Children in Medicaid and SCHIP, January 2009.
This report explains eligibility rules and enrollment procedures and mentions enrollment issues pertaining to reauthorization.
Ryan, J. and S. Mojerie. Covering All Kids: States Setting the Pace. National Health Policy Forum. Issue Brief: No. 826 September 30, 2008
This issue brief provides a history and status of state universal children’s coverage initiatives and features several states that appear to be setting the pace by developing successful strategies for expansion and cultivating the political will and leadership needed to institute them. In highlighting some of the key lessons that can be learned from states’ experiences, this paper may inform the broader discussion about health reform and offer some insights into the federal-state dynamics that are at play.
Wachino, V. and Weiss A.M. Maximizing Kids’ Enrollment in Medicaid and SCHIP: What Works in Reaching, Enrolling and Retaining Eligible Children. Robert Wood Johnson Foundation. February 2009.
This paper revisits major strategies for states seeking to take the next step in enrolling more uninsured children who are eligible for Medicaid or SCHIP, but not enrolled.
Allen, K.G., Government Accountability Office, State Experiences in Implementing SCHIP and Considerations for Reauthorization, Testimony to the Senate Committee on Finance on February 1, 2007.
This testimony addresses trends in SCHIP enrollment and the current composition of SCHIP programs across the states, states’ spending experiences under SCHIP, and considerations GAO has identified for SCHIP reauthorization. GAO’s testimony is based on its prior analysis of the Current Population Survey
Cuttler, L., and G. Kenney. Update on the State Children's Health Insurance Program. Arch Pediatr Adolesc Med. 2009;163(2):103-107.
This article outlines Congress’s SCHIP proposals and alternative options, funding, eligibility, quality and access to care, and enrollment and retention. It discusses why SCHIP was not reauthorized in 2007, the future of SCHIP, and its effects on children and pediatricians.
Iglehart, J. Expanding Coverage for Children – The Democrats’ Power and SCHIP Reauthorization. NEJM Volume 350:855-857. February 26, 2009.
This article comments on the political climate surrounding the passage of CHIPRA legislation in February 2009 and the implications for larger system-wide reform efforts.
Georgetown University Health Policy Institute Center for Children and Families, Children’s Health Insurance Program Reauthorization Act of 2009: Overview and Summary, March 2009.
This report gives an overview of key elements of the new law, as well as a more detailed summary of each of its provisions.
Georgetown University Health Policy Institute Center for Children and Families, Implementation Dates of Key CHIPRA Provisions.
This document outlines important dates regarding the implementation of CHIPRA provisions, from the signing of the bill into law in February 2009 to the final provision implementations in September 2011.
Georgetown University Health Policy Institute Center for Children and Families, Key Events in SCHIP Reauthorization, 2007-2009.
This document highlights important dates during the SCHIP Reauthorization process, from February 2007 to February 2009, when President Obama signed the Children’s Health Insurance Program Reauthorization Act of 2009 into law.
Kaiser Commission on Medicaid and the Uninsured, Children’s Health Insurance Program Reauthorization Act Of 2009 (CHIPRA). February 2009.
This fact sheet provides an overview of provisions of the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA), which was signed into law in February 2009. The Act extends and expands the State Children's Health Insurance Program (now referred to as CHIP, not SCHIP) that was enacted with bipartisan support a decade ago as part of the Balanced Budget Act of 1997 (BBA).
Kaiser Commission on Medicaid and the Uninsured, State Children’s Health Insurance Program (SCHIP): Reauthorization History, February 12, 2009.
This fact sheet provides an overview of the reauthorization debate for the State Children's Health Insurance Program.
National Association of Children’s Hospitals.
The National Association of Children’s Hospitals is a trade organization of children’s hospitals and addresses public policy issues that affect their ability to fulfill their missions to serve children and their families. It joined with other key child health organizations to identify key issues in SCHIP’s reauthorization and advocate on its behalf.
Reauthorizing SCHIP: A summary of Selected Issues (January 8, 2009). National Health Policy Forum.
This document provides a brief overview of some of the policy and programmatic issues that were addressed in legislation to reauthorize the State Children’s Health Insurance Program (Title XXI of the Social Security Act) during the summer and fall of 2007. This overview provides a background for understanding the elements for a second round of reauthorization that will likely be debated in the early days of the 111th Congress. The paper reviews several of the key issues under discussion and summarizes some of the related provisions in the reauthorization bills that were considered in 2007.
Congressional Budget Office Cost Estimate. February 11, 2009 H.R. 2 Children’s Health Insurance Program Reauthorization Act of 2009.
This document summarizes the CBO’s cost estimate analysis of the CHIP reauthorization legislation.
Peterson, C. Projections of FY2009 Federal SCHIP Allotments Under CHIPRA 2009, January 14, 2009
This report shows FY2009 federal State Children’s Health Insurance Program (SCHIP) allotments as well as projected federal SCHIP allotments under the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA 2009), based partly on states’ own projections of federal SCHIP spending submitted in November 2008.
Ryan, J. SCHIP Financing. National Health Policy Forum, January 15, 2009.
This document is intended to offer the basic elements of the financing structure of the State Children's Health Insurance Program. Key concepts including the enhanced match, allotments and redistribution of SCHIP funds are described.
Ryan, J. Medicaid Financing. National Health Policy Forum, January 15, 2009.
This publication provides an overview of how the Medicaid program is financed. It explains the basic structure of the federal-state matching relationship and briefly describes how money flows from the federal government to the states as well as some of the strategies states have identified to help them maximize federal Medicaid matching funds.