Bipartisan Congressional Health Policy Conference The State Children

1
Bipartisan Congressional Health Policy
ConferenceThe State Childrens Health Insurance
Program Achievements and Opportunities for
Improvement at Renewal

• January 12-14, 2007
• Anne Gauthier
• Senior Policy Director
• Commission on a High Performance Health System
• The Commonwealth Fund

2
SCHIP The Basic Design

• Adopted as part of the Balanced Budget Act of
  1997 (P.L. 105-33) to expand health insurance
  coverage for low-income children
• States may develop SCHIP programs by expanding
  Medicaid programs, developing alternative,
  stand-alone state SCHIP programs, or creating a
  program that is a combination of Medicaid and
  SCHIP
• SCHIP is financed by both the federal and state
  governments and is administered by the states
• Within federal guidelines, each state determines
  its specific program design, eligibility
  categories, covered benefits, provider payments,
  and administrative and operating procedures.
• States receive an enhanced federal matching rate
  that exceeds their federal Medicaid match by
  about 30 percent, with the federal share capped
  at 85 percent.

3
U.S. SCHIP Enrollment of ChildrenJune of Each
Year vs. Number of Uninsured Children, 2001-2005
Number of Children (in millions)
9.6
2.2
Change in SCHIP Enrollment
-1.4
18.97
Source Data provided by state officials to
Health Management Associates for the Kaiser
Commission on Medicaid and the Uninsured CBO
Analysis of Current Population Survery.
4
State Variation in Type of SCHIP Program
WA
ME
NH
VT
MT
ND
MN
OR
WI
NY
MA
ID
SD
MI
RI
WY
CT
NJ
PA
IA
OH
NE
DE
NV
IN
IL
WV
MD
UT
VA
DC
CO
CA
KS
MO
KY
NC
TN
OK
AR
SC
NM
AZ
AL
GA
MS
TX
LA
AK
FL
FL
Percent of Federal Poverty Level
Separate SCHIP
Medicaid Expansion
SCHIP/Medicaid Combo
Source Kaiser Family Foundation,
Statehealthfacts.org.
No Data Available
5
Income Eligibility Levels for Children's Separate
SCHIP Programs by as a Percent of Federal Poverty
Level, 2005
WA
ME
NH
VT
MT
ND
MN
OR
WI
NY
MA
ID
SD
MI
RI
WY
CT
NJ
PA
IA
NE
OH
DE
NV
IN
IL
WV
MD
UT
VA
DC
CO
CA
KS
MO
KY
NC
TN
OK
AR
SC
NM
AZ
AL
GA
MS
TX
LA
AK
FL
Percent of Federal Poverty Level
Less than 200
200-220
More than 220
Source Kaiser Family Foundation,
Statehealthfacts.org.
No Data Available
6
SCHIP Reauthorization

• SCHIPs current period of authorization is
  scheduled to end after federal fiscal year
  2007
• SCHIP has strong support from the states and the
  public. Discussion leading up to reauthorization
  will include options to
• Provide the SCHIP funding needed to cover more
  children
• Eliminate enrollment barriers that prevent
  eligible children from receiving coverage
• Promote coverage that facilitates the healthy
  development of children

7
SCHIP Panel

• Debbie Chang, Senior Vice President and Executive
  Director, Nemours Health and Prevention Services
  
• Gayle Lees Sandlin, Director, Childrens Health
  Insurance Program. Alabama Department of Public
  Health
• Jeanne Lambrew, Associate Professor, George
  Washington University