Children's Health Insurance Program (CHIP)
Since its creation in 1997, the Children’s Health Insurance Program (CHIP) has allowed states to expand health coverage voluntarily to children in families with incomes too high to qualify for traditional Medicaid but too low to afford private health insurance. Approximately 8 million children are currently covered through the program.
Under the Patient Protection and Affordable Care Act (ACA), improvements in Medicaid and CHIP, along with Health Insurance Marketplaces (formerly Exchanges), will expand coverage to millions of uninsured Americans. Use of consistent standards and systems across Medicaid and CHIP will help states more effectively meet consumers’ health care needs, while improving quality and reducing costs.
Specifically, the ACA will streamline income-based rules and systems for processing Medicaid and CHIP applications and renewals for most individuals. Eligibility, enrollment, and renewal processes will be modernized using approaches pioneered at the state level.
CHIP is not an entitlement, but rather an optional program in which states may elect to participate. The program provides states with flexibility and additional funds to cover low-income, uninsured children. Those federal funds are capped; when a state’s CHIP funds are spent, no more are available (with some exceptions). This differs from Medicaid, which, as an entitlement, requires the state to enroll all qualified applicants and allows the state to draw down federal funds to help cover any enrollees beyond its budgeted projection.
Because nearly 65 percent of family physicians participate in Medicaid and provide care for children, AAFP members have a major stake in ensuring CHIP remains a viable and useful means for providing care to at-risk children. For that reason, the AAFP will continue to participate in the debate and discussion surrounding the program’s improvements and modifications.
Joint Letter Applauding Final Mental Health Parity Rule - January 8, 2014(2 page PDF)
Letter to Congress Regarding Pediatric Community Medicaid Payment Increase - December 12, 2012(2 page PDF)
Letter to AHRQ on the CHIPRA Pediatric Quality Measures Program - January 12, 2011(2 page PDF)
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