State Children's Health Insurance Program
From dKosopedia
Categories: Healthcare | Medicare | Medicaid
The State Children’s Health Insurance Program (SCHIP) is a national program in the United States designed for families who earn too much money to qualify for Medicaid, yet cannot afford to buy private insurance. The program was created to address the growing problem of children in the United States without health insurance. At its creation in 1997, SCHIP was the largest expansion of health insurance coverage for children in the United States since Medicaid began in the 1960s. The statutory authority for SCHIP is under Title XXI of the Social Security Act.
SCHIP covered over 6 million children at some point during Federal fiscal year 2005 and every state has an approved state plan. The program's success can be attributed the flexibility allowed to states and the enhanced match that is paid to states. Some states have received section 1115 demonstration authority to use SCHIP funds to cover the parents of children receiving benefits from both SCHIP and Medicaid, pregnant women, and other adults.
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Federal money with State administration
Like Medicaid, SCHIP is a partnership between Federal and state governments. The programs are run by the individual states according to requirements set by the federal Centers for Medicare and Medicaid Services. States may design their SCHIP program as an independent program that is separate from Medicaid (separate child health programs), use SCHIP funds to expand their Medicaid program (SCHIP Medicaid expansion programs), or combine these approaches (SCHIP combination programs). States receive enhanced Federal funds for their SCHIP programs at a rate above the regular Medicaid match.
States with separate child health programs follow the regulations described in section 42 of the Code of Federal Regulations, section 457. Separate child health programs have much more flexibility than Medicaid programs. Separate programs can impose cost sharing, tailor their benefit packages, and have a great deal of flexibility in eligibility and enrollment matters. The limits to this flexibility are described in the regulations and states must describe their program characteristics in their SCHIP state plans.
In the state of Ohio, SCHIP funds are used to expand eligibility for the State's Medicaid program. As a SCHIP Medicaid expansion program, all Medicaid rules and regulations (including cost sharing and benefits) apply. Children from birth through age 18 who live in families with incomes above the Medicaid thresholds in 1997 and up to 200% of the federal poverty level, are eligible for the SCHIP Medicaid expansion program. In 2004, the maximum annual income needed for a family of four to fall within 100% of the federal poverty guidelines was $18,850, while 200% of the poverty guidelines was $37,700.
Other states have similar SCHIP guidelines, with some states being more generous or restrictive in the number of children they allow into the program. SCHIP Medicaid expansion programs typically use the same names for the expansion and Medicaid programs and separate child health programs typically have different names for their programs. A few states also call the SCHIP program by the term Children's Health Insurance Program (CHIP).
Resources
See also
Sources
- This article uses material from the Wikipedia article "State Children's Health Insurance Program"
- SCHIP Summary - Centers for Medicare and Medicaid Services
- Ohio Medicaid Basics - Health Policy Institute of Ohio
External links
- Portal for SCHIP information at cms.hhs.gov
- Congressional Research Service (CRS) Reports regarding SCHIP
- Kaiser Foundation Resources on SCHIP - wide range of background information, fact sheets, and studies on SCHIP and other U.S. health programs.
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