The Legacy of CHIP in America

Much like Medicaid, the state-administered health insurance program for Americans living in poverty, the CHIP (Children’s Health Insurance Program), is formally overseen by the department of Health and Human Services on a federal level. States are primarily responsible for CHIP’s everyday administration. That is why the benefits accorded through CHIP to children and their families vary between states (“CHIP,” 2017). The federal law does mandate that certain aspects of children’s healthcare must be covered, including check-ups, vaccines, prescriptions, vision care, dental care, most types of hospital care, laboratory and other screening services, and ER visits (“CHIP,” 2017). Some states require copay payments and premiums but premiums cannot exceed 5% of the family’s monthly income (“CHIP,” 2017). CHIPs is funded by a combination of federal and state funds and overseen by a combination of federal and state health agencies. Matching grants are issued to states by the federal government to ensure continued funding of CHIP (Paradise 2014).
According to Paradise (2014), since the original form of CHIP was enacted in 1997, “Medicaid and CHIP have significantly expanded health coverage among US children and provided a coverage safety-net for children in working families during economic downturns” (par.2). The legislation was specifically designed to address the problem of children of parents who were not eligible for Medicaid, did not have health insurance, and could not purchase affordable healthcare for their children.
The legislation reflected the belief that healthcare is a basic right for children and that offering comprehensive care to children was essential to enable them to become productive citizens and maximize their educational experience. In fact, studies suggest that “children covered by Medicaid and CHIP fare as well as privately insured children on measures of primary and preventive care access” (Paradise, 2014, par. 3). The legislation has thus had a profoundly positive, equalizing effect upon access and quality of care for children, regardless of income level. This allows children living in poverty or close to poverty to have equal access to the same providers as middle-class children. The program has continued to be popular among families and is considered to be effective, given that healthcare access is still limited for many families.
Health care managers must be aware of what families qualify for CHIP, how families should apply, and differences between states regarding healthcare policy. Given the complexity of healthcare bureaucracy in the United States, parents may be unaware of the fact that their children may qualify for assistance even if the family does not. For example, according to the official website of CHIP for the state of Pennsylvania, children are eligible if:
· They are under the age of 19
· A state resident
· A citizen or lawful immigrant (even if the child’s parent is not a lawful immigrant)
· Uninsured
· Not eligible for another form of assistance
CHIP thus provides an important stopgap for the state, in ensuring that children who are from families without other forms of access to healthcare still are covered, although the state takes measures to ensure there is not overlapping coverage. This may mean that parents who still cannot afford insurance purchased through the healthcare exchanges created by the Affordable Care Act (ACA) may have children covered through CHIP, as many parents who are not in the country lawfully and who are not eligible for health insurance assistance themselves.
References
CHIP (Children’s Health Insurance Program). (2017). Healthcare.gov. Retrieved from:
https://www.healthcare.gov/medicaid-chip/childrens-health-insurance-program/
CHIP PA. (2016). Retrieved from;
http://www.chipcoverspakids.com/Eligibility/Pages/default.aspx
Paradise, J. (2014). Impact of the Children’s Health Insurance Program: What does research tell us? Kaiser Family Foundation. Retrieved from:
http://www.kff.org/medicaid/issue-brief/the-impact-of-the-childrens-health-insurance- program-chip-what-does-the-research-tell-us/