The Children's Health Insurance Program (CHIP)

On February 4, 2009, President Obama signed the Children's Health Insurance Program Reauthorization Act (CHIPRA), which renews and expands coverage of the Children's Health Insurance Program (CHIP) from 7 million children to 11 million children.  CHIP was previously known as the State Children's Health Insurance Program (SCHIP).

Originally created in 1997, CHIP is Title XXI of the Social Security Act and is a state and federal partnership that targets uninsured children and pregnant women in families with incomes too high to qualify for most state Medicaid programs, but often too low to afford private coverage.  Within Federal guidelines, each State determines the design of its individual CHIP program, including eligibility parameters, benefit packages, payment levels for coverage, and administrative procedures.

In addition to renewing the CHIP program, the new legislation makes it easier for certain groups to access CHIP health care, including uninsured children from families with higher incomes and uninsured low-income pregnant women.

Centers for Medicare & Medicaid Services (CMS) enrollment data based on state reports show that 7.4 million children were enrolled in CHIP at some point during Federal fiscal year (FFY) 2008, compared to 7.1 million for fiscal 2007.  During FFY 2008, there were 334,616 adults covered with CHIP funds.

Children's Health Insurance Program (CHIP) Directors.  Each State, Territory, and the District of Columbia has a coordinator for the SCHIP program who is responsible for the administration of the approved SCHIP state plan.

Children's Health Insurance Program (CHIP) Waivers and Demonstrations.  The Social Security Act authorizes multiple waiver and demonstration authorities to allow states flexibility in operating Medicaid programs and CHIP programs. Each authority has a distinct purpose, and distinct requirements.

 CMS is responsible for supporting State Medicaid and CHIP programs in their efforts to achieve safe, effective, efficient, patient-centered, timely and equitable care. CMS will partner with States to share best practices, provide technical assistance to improve performance measurement, evaluate current improvement efforts to inform future activities, collaborate with quality partners and coordinate Center activities to ensure efficiency of operations.

CMS recently developed a Medicaid/CHIP Quality Strategy. Key strategies include: (1) Evidenced-Based Care and Quality Measurement (2) Payment Aligned with Quality (3) Health Information Technology (4) Partnerships (5) Information Dissemination, Technical Assistance, and sharing of best practices.