CHIP Works – What’s next?
Carrie Fitzgerald
Children in the Budget:
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.
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Children in the Budget:
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.
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Children inSigned
the Budget:
CHIPRA
in February
2009
• The five year anniversary of the signing of
CHIPRA – February 4th (Children’s Health
Insurance Program Reauthorization Act)
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Children in the Budget:
CHIPRA 2009
 $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
Children in the Budget:
CHIP Covers Kids
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Children in the Budget:
CHIP Enrollment 2002-2012
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Children
in the Budget:
CHIP
– Where
Does It Stand
Now?
• CHIPRA funded CHIP until 2013
• The Affordable Care Act authorizes CHIP
until 2019 and funds it through FY2015
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Children in the Budget:
WHAT IF…
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Children
in the Budget:
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.
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Children
the Budget: Plans: What is Best
CHIP
vs.inExchange
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
Children in the Budget:
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
Children in the Budget:
CHIP Compared to Exchange Plans
FIGURE 3:
FAMILY’S TOTAL EXPENSE TO COVER ONE CHILD IN TOP 10% OF USERS, 2010
(225% FPL)
n/a
Senate Finance estimate based on Silver plan.
“n/a” indicates states that do not offer CHIP coverage at 225% FPL.
n/a
Children in the Budget:
How Can We Protect CHIP?
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Children in
the Budget:
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
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th –
Children in4the
Budget:
February
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
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Children in the Budget:
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
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Children in the Budget:
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
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Children in the Budget:
Do What You DO Best!
SOCIAL MEDIA
PRESS EVENTS
OP-EDS , Letters to the Editor
VIDEOS
Events with Your Governor or Congressional Members
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Children in the Budget:
The Road Ahead: Steps to Achieve Success
Protect
Child
Cover
Health
All
Kids
CHIP
Works
• 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
Children in the Budget:
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!!
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Children in the Budget:
Thank You!
www.firstfocus.net
Carrie Fitzgerald
202-657-0663
www.firstfocus.net