The Children's Health Insurance Program (CHIP) – formerly known as the State Children's Health Insurance Program (SCHIP) – is a program administered by the United States Department of Health and Human Services that provides matching funds to states for health insurance to families with children. The program was designed to cover uninsured children in families with incomes that are modest but too high to qualify for Medicaid. The program was passed into law as part of the Balanced Budget Act of 1997, and the statutory authority for CHIP is under title XXI of the Social Security Act.
CHIP was formulated in the aftermath of the failure of President Bill Clinton's comprehensive health care reform proposal. Legislation to create CHIP was co-sponsored by Democratic Senator Ted Kennedy and Republican Senator Orrin Hatch, and received strong support from First Lady Hillary Clinton. Despite opposition from some conservatives, SCHIP was included in the Balanced Budget Act of 1997, which President Clinton signed into law in August 1997. At the time of its creation, SCHIP represented the largest expansion of taxpayer-funded health insurance coverage for children in the U.S. since the establishment of Medicaid in 1965. The Children's Health Insurance Reauthorization Act of 2009 extended CHIP and expanded the program to cover an additional 4 million children and pregnant women, and the Bipartisan Budget Act of 2018 extended CHIP's authorization through 2027.
CHIP was designed as a federal-state partnership similar to Medicaid; programs are run by the individual states according to requirements set by the federal Centers for Medicare and Medicaid Services. States are given flexibility in designing their CHIP policies within broad federal guidelines, resulting in variations regarding eligibility, benefits, and administration across different states. Many states contract with private companies to administer some portions of their CHIP benefits. Some states have received authority to use CHIP funds to cover certain adults, including pregnant women and parents of children receiving benefits from both CHIP and Medicaid.
CHIP covered 7.6 million children during federal fiscal year 2010, and every state has an approved plan. Nonetheless, the number of uninsured children continued to rise after 1997, particularly among families that did not qualify for CHIP. An October 2007 study by the Vimo Research Group found that 68.7 percent of newly uninsured children were in families whose incomes were 200 percent of the federal poverty level or higher as more employers dropped dependents or dropped coverage altogether due to annual premiums nearly doubling between 2000 and 2006. A 2007 study from researchers at Brigham Young University and Arizona State found that children who drop out of CHIP cost their states more money due to the increased use of emergency care. A 2018 survey of the existing research noted that the availability of "CHIP coverage for children has led to improvements in access to health care and to improvements in health over both the short-run and the long-run."
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