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CHIP Works – What ’ s next? Carrie Fitzgerald. A Little Bit of Background. The State Children ’ s Health Insurance Program (SCHIP) was created in 1997 to insure children in families with too much income to qualify for Medicaid and too little to afford private insurance.

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Presentation Transcript
a little bit of background
A Little Bit of Background
  • The State Children’s Health Insurance Program (SCHIP) was created in 1997 to insure children in families with too much income to qualify for Medicaid and too little to afford private insurance.
  • States have the option of providing coverage in CHIP through Medicaid, a separate program, or a combination of the two.

a little more background
A Little More Background
  • There is also flexibility in benefit design, though benefits must meet certain set standards.
  • As in Medicaid, state payments for CHIP qualify for federal matching payments. On average, the federal government pays 70 percent and state governments pay 30 percent of program costs.

chipra signed in february 2009
CHIPRA Signed in February 2009
  • The five year anniversary of the signing of CHIPRA – February 4th(Children’s Health Insurance Program Reauthorization Act)

  • $32.8 billion, 5-year reauthorization
  • Eligibility Changes
    • Legal immigrant children and pregnant women
    • Low-income pregnant women
  • Outreach and Enrollment
    • Express Lane Eligibility
    • $100 million in outreach and enrollment grants
  • Benefit Improvements
    • Dental benefits
    • Mental health parity
chip covers kids
CHIP Covers Kids

chip enrollment 2002 2012
CHIP Enrollment 2002-2012

chip where does it stand now
CHIP – Where Does It Stand Now?

CHIPRA fundedCHIP until 2013

The Affordable Care Act authorizes CHIP until 2019 and funds it through FY2015

what if

what happens if chip goes away
What Happens If CHIP Goes Away?
  • The Government Accountability Office (GAO) says that two million children will go uninsured due to the kid glitch/affordability test.
  • The rest will likely go into plans in the Marketplaces. Those plans may not have the same cost protections, provider networks, and benefits as CHIP.

chip vs exchange plans what is best for low income children
CHIP vs. Exchange Plans: What is Best for Low-Income Children?

CHIP is Clearly Better at This Point

  • Benefits – CHIP
  • Affordability: Premiums/Cost Sharing - CHIP
  • Adequacy of Pediatric Provider Networks - CHIP
  • Guarantee of Coverage/Entitlement - CHIP
  • Family Coverage - Exchanges
  • Focus on Pediatric Quality of Care - CHIP
chip compared to exchange plans
CHIP Compared to Exchange Plans

FIGURE 1:Actuarial Values for Children in 17 State CHIP Programs and 3 Benchmark Plans, 2010 (175% FPL)

*Senate HELP bill requires plan at least equivalent to typical employer-based plan.

CA: 0.980, CO: 0.984, CT: 1.000, DC: 1.000, IA: 1.000, MD: 1.000, ME: 1.000, MT: 0.984, NC: 0.989, NH: 1.000, NM: 1.000, NV: 1.000, NY: 1.000, PA: 1.000, TX: 0.964, WA: 1.000, WV: 0.922

chip compared to exchange plans1
CHIP Compared to Exchange Plans




Senate Finance estimate based on Silver plan. “n/a” indicates states that do not offer CHIP coverage at 225% FPL.

how can we protect chip
How Can We Protect CHIP?

national health advocates working on chip strategy
National Health Advocates Working on CHIP Strategy:
  • First Focus
  • Children’s Defense Fund
  • American Academy of Pediatrics
  • Children’s Hospital Association
  • March of Dimes
  • Family Voices
  • Georgetown Center for Children and Families

february 4 th chipra 5 th anniversary
February 4th – CHIPRA 5th Anniversary
  • Launch Day for Efforts to Renew Funding
  • Event with Senator Rockefeller’s (D-WV) Office
  • Senator Rockefeller Will File a Bill in Late February or Early March
  • Hearing on the Hill in March

what state advocates can do
What State Advocates Can Do
  • Promote the success of CHIP in your state
  • Celebrate the five year anniversary of CHIPRA
  • Talk to the press about CHIP stories
  • Meet with your congressional delegation about CHIP

voters want to protect chip
Voters Want to Protect CHIP

Oppose CHIP Cuts

Support CHIP Cuts

Don’t Know

Source: First Focus Campaign for Children, research by Public Opinion Strategies, 2012

do what you do best
Do What You DO Best!



OP-EDS , Letters to the Editor


Events with Your Governor or Congressional Members

the road ahead steps to achieve success
The Road Ahead: Steps to Achieve Success

Protect Child Health




All Kids

Increase Knowledge: Share research/data, family stories

Support Agenda: Strong & unified voice

Build Will: Coalition building, find champions, & communications/messaging

Take Action/Create Opportunities: Celebrate wins & make/take advantage of opportunities

please keep in touch
Please Keep in Touch

Send info on what your Governor is saying

Share info from your congressional visits

Send us media clips and press coverage

Ask us for help!!

thank you
Thank You!

Carrie Fitzgerald