What is SCHIP?
SCHIP stands for "State Children's Health Insurance Program". It was created in 1997 under the Balanced Budget Act.
Like Medicaid, SCHIP is a program which was created by the federal government, but is operated at the state level. This means that each state has its own SCHIP program which receives funding from both the federal government and the state government.
The purpose of SCHIP is to provide insurance benefits to children whose families make too much money to qualify for Medicaid, but not enough to be able to afford to buy a policy in the private insurance market.
Who is eligible for SCHIP?
As mentioned earlier, each state operates its own SCHIP program, and therefore has its own eligibility requirements.
Most states will cover children whose family income is at or below 200% of the Federal Poverty Level (FPL). Five states (Idaho, Nebraska, Oklahoma, Oregon, and Wisconsin) cover children whose family income is at or below 175% of the FPL, while four other states have lower thresholds. On the other hand, some states are more generous - for example, New Jersey covers children whose families have incomes at or below 350% of the FPL.
Although SCHIP is intended to primarily benefit children, fourteen states extend coverage to adults. Most of these adults are either parents of SCHIP-eligible children or pregnant women, but some states have used SCHIP as a vehicle to expand coverage to uninsured childless adults who meet the income requirements.
How is SCHIP structured?
The Balanced Budget Act gave each state the authority to decide how it was going to structure its own SCHIP program.
Ten states and the District of Columbia created their SCHIP program by expanding their already existing state Medicaid program. These states are: Alaska, Hawaii, Louisiana, Missouri, Nebraska, New Mexico, Ohio, Oklahoma, South Carolina, and Wisconsin.
Eighteen states created separate, stand-alone SCHIP programs. These states are: Alabama, Arizona, Colorado, Connecticut, Georgia, Kansas, Mississippi, Montana, Nevada, New York, Oregon, Pennsylvania, Texas, Utah, Vermont, Washington, West Virginia, and Wyoming.
Twenty-one states used a combination of these two approaches to create their SCHIP program. These states are: Arkansas, California, Delaware, Florida, Idaho, Illinois, Indiana, Iowa, Kentucky, Maine, Maryland, Massachusetts, Michigan, Minnesota, New Hampshire, New Jersey, North Carolina, North Dakota, Rhode Island, South Dakota, and Virginia.
The one remaining state, Tennessee, does not currently have an active SCHIP program, although according to the Government Accountability Office, their plans for a new SCHIP program were approved in January 2007.
The Future of SCHIP
Federal funding for SCHIP expires in 2007. Congress is currently debating reauthorization of the program. Members from both sides of the aisle agree that the program should be continued, but disagree on the details, particularly the level of funding. SCHIP has cost the federal government significantly more than anticipated, and some states could potentially run out of money for their programs before reauthorization.
Also, look for some debate about eligibility for the program, including possible discontinuation of the waivers which allow states to cover adults under SCHIP, or lowering the income level which triggers SCHIP eligibility. Also, there may be some discussion about whether SCHIP should be used as a model to expand coverage to all uninsured Americans, or whether eligibility and benefits should be strictly limited in scope.
