Children’s Health Insurance Resources

Through Medicaid and the Children’s Health Insurance Program (CHIP), states and the nation have made substantial progress in covering children and improving their access to quality health care supporting healthy growth and development. With ongoing funding from the David and Lucile Packard Foundation, NASHP has supported, analyzed, and reported on state efforts to extend children’s coverage since the CHIP program’s inception, building on our longstanding work on Medicaid. NASHP supports active state-to-state exchange and collaborative learning by regularly convening state officials working on children’s coverage issues. The resources listed below are intended to provide information about children’s coverage for state and federal program administrators and policymakers as well as other stakeholders and can help inform state and national policy discussions about the future of children’s coverage.


How the Bipartisan Budget Act Impacts Key State Health Care Programs
The president’s recently-released 2019 budget proposes $17.9 billion in cuts to health programs that states rely on to provide health care and other supports to their vulnerable populations. Click here for a summary of how the proposal would impact Medicaid, health insurance, the Children’s Health Insurance Program, safety net programs including health centers, nutrition, and prescription drug costs. The budget now heads to Congress, where the proposed cuts are expected to be contested and modified.

Latest Continuing Resolution Funds Six Years of CHIP
Yesterday, after a three-day federal government shutdown, Congress passed a continuing resolution bill to keep the federal government operating through Feb. 8, 2018. After months of delay, the bill finally funded the Children’s Health Insurance Program for six years. Read more.

State CHIP Officials Speak Out on Impact of Congressional Funding Delay
A confidential poll of state CHIP and Medicaid directors found widespread concern that continued Congressional delays in extending CHIP funding will soon result in children losing health coverage and cause problems for state agencies, coverage programs, and provider networks that may linger for months even after the funding uncertainty is resolved. Read more.

Where Are We with CHIP Now?
Congress’ short-term patch for the Children’s Health Insurance Program (CHIP) program does not provide enough funding for all states through March. Uncertainty about federal funding for the program persists with officials from at least 10 states predicting they will exhaust their remaining funds as early as January and February. Find out where states stand in the effort to preserve health insurance for millions of children. Read more.

Short-Term CHIP Funding Included in December 2017 Continuing Resolution
On Dec. 21,2017, Congress passed a continuing resolution bill to keep the federal government operational through Jan. 19, 2018, that includes new, short-term federal funding for the Children’s Health Insurance Program (CHIP). Read this update to discover what the resolution funds and for how long.

December Is the Most Critical Month Yet for States’ CHIP Funding
Months have passed and Congress has yet to extend funding for the Children’s Health Insurance Program (CHIP) that covers millions of children. Even with federal redistribution of funds and last-minute work-arounds, some states may be forced to send notices out to families warning them that coverage may end just in time for the holidays. Read more.

Congressional Agreement on CHIP Needed Soon!
Congress has repeatedly promised state officials that there is broad support for the Children’s Health Insurance Program (CHIP), and new funds will be available soon. But over a month has passed since funding expired and it is still unclear if and when Congress will successfully pass a bill to fund CHIP. As stewards of CHIP health insurance coverage for low- and moderate-income children and pregnant women, state officials must now consider what is best for families and try to maintain this coverage for as long as possible as they wrestle with how to chart the path ahead. Read more.

Week Three — Where Are We Now with CHIP Funding?
Congress missed the Sept. 30 deadline to fund the Children’s Health Insurance Program (CHIP) that covers an estimated 9 million children. There are two bills to reauthorize CHIP, but it’s unclear when Congress will act. Meanwhile, states are running out of their CHIP 2017 carryover funds. What does this mean for states’ CHIP funding? Read Maureen Hensley-Quinn’s blog to find out.

Update: What’s Happening with CHIP?
The Sept. 30, 2017, deadline has come and gone and Congress has not yet extended federal funding for the Children’s Health Insurance Program (CHIP), but for now, the estimated 9 million children enrolled in the program remain covered. This is possible because CHIP, a block grant-funded program, provided annual allotments to states and a portion of states’ unspent 2017 fiscal year allotment can be used to continue to support the program. This is a short-term solution because these funds are limited. Without Congressional action to provide additional funding, the federal government predicts a national CHIP shortfall of $13 billion in fiscal year 2018. There remains approximately $3 billion in unspent CHIP dollars from previous years that will be redistributed proportionately to states as their CHIP funds run out, but it is not clear exactly how much each state will receive. Federal estimates suggest on average each state will be able to fund one or two more months of CHIP, but this projection doesn’t take into consideration unanticipated costs, such as increased enrollment or high utilization. State officials do not want to dis-enroll children from CHIP, but their budgets cannot absorb the nation’s $10 billion shortfall. Congress must act soon as some states are expected to exhaust their CHIP funds as early as November. NASHP will continue to track states’ efforts to maintain this successful program during this uncertain time.

CHIP’s Future: There Are Hopeful Signs from Congress, But States Still Face Uncertainty
With less than two weeks to go before current federal funding for the Children’s Health Insurance Program (CHIP) ends, Sens. Orrin Hatch and Ron Wyden introduced a bipartisan bill to extend the program for five years. However, state officials face the unsettling possibility that if Congress is unable to pass legislation and appropriate funds soon, some states may have to make tough decisions as soon as mid-October. Read more in our blog.

Increasing Urgency for States on Congressional Action for CHIP
We are five weeks away from September 30th, the date current federal funding for the Children’s Health Insurance Program (CHIP) is set to end. Learn more in our latest blog.

State CHIP Changes are Coming Soon
This blog explores increased pressure on states because federal funding for the Children’s Health Insurance Program (CHIP) remains uncertain beyond September 30.

CHIP and Medicaid are Essential Partners for Cross Agency Collaboration to Better Serve Children
This blog looks at how Massachusetts and D.C. are using their CHIP and Medicaid programs to create improved coordination across multiple state agencies and programs serving youth.

The Clock is Ticking as We Enter a Critical Time for the Future of CHIP
This blog highlights for federal and state policymakers and other stakeholders the main policy and programmatic issues and critical decision points that states would confront if federal CHIP funding remains uncertain in the coming months, and provides links to other resources on the topic.

Planning Now: State Policy and Operational Considerations if Federal CHIP Funding Ends
This blog outlines some of the main policy and operational issues and changes for states if federal CHIP funding is not extended beyond September 2017 and provides context about some of the factors that add complexity to state decision making.


State Checklist for Shutting Down CHIP Programs
Congress has not provided new funding for the Children’s Health Insurance Program (CHIP), and states are beginning to run out of CHIP funds. The 42 states with separate CHIP programs will need to begin closing them in the coming weeks and months, which will be very challenging, costly, and time consuming. See NASHP’s infographic that outlines the many tasks and hard choices that states now face.

State CHIP Fact Sheets
These fact sheets provide key, up-to-date information about the Children’s Health Insurance Program (CHIP) for each state, including data on enrollment, participation rates, eligibility levels, benefits, cost sharing requirements, and other key program characteristics.

Children’s Health Insurance Program Frequently Asked Questions
The Children’s Health Insurance Program (CHIP) was enacted in 1997 under Title XXI of the Social Security Act and has since provided critical health coverage to children in families with low to moderate income. In FY2016 more than 8.9 million children were enrolled in CHIP. This factsheet is intended to provide an overview of CHIP

Looking Ahead: A Timeline of State Policy and Operational Considerations if Federal CHIP Funding Ends for States
This timeline highlights the main policy and programmatic issues and critical decision points that states would confront if federal CHIP funding remains uncertain beyond September 2017.

Toolbox for Advancing Children’s Coverage through Health Reform Implementation
This online resource is a comprehensive and centralized source of information related to the impact of the ACA on children’s coverage, and includes relevant research and state examples.


State Perspectives on Children’s Coverage in the Changing Health Policy Landscape
This brief highlights the main themes from a February 2017 discussion with CHIP and Medicaid officials about ways to ensure that children’s health coverage needs continue to be met in the changing health policy environment.

Summary of NASHP’s 2017 CHIP Directors Survey
This February 2017 summary of NASHP’s survey of state CHIP officials highlights how states are budgeting and planning for CHIP considering its uncertain future beyond September 2017.

Potential Options and Policy Questions for Improving Exchange Coverage for Children
This brief examines potential options and policy questions for improving exchange coverage for children in terms of both affordability and pediatric benefit adequacy. In May 2016, NASHP convened a group of stakeholders including state officials, health policy researchers and advocates to explore ways to maintain affordable and comprehensive children’s coverage, and the brief summarizes the key themes from the group’s discussion.

Using CHIP and the ACA to Better Serve Children Now and in the Future
This March 2016 brief provides an overview of children’s current coverage options and summarizes the themes from a September 2015 stakeholder group discussion focused on identifying potential options for ensuring strong children’s coverage into the future.

Benefits and Cost Sharing in Separate CHIP Programs
This report, developed jointly with the Georgetown University Center for Children and Families, examines the scope of coverage and cost sharing in separate CHIP programs and can help inform discussions related to how CHIP compares to qualified health plans.

Health Care Reform and Children: Planning and Design Considerations for Policymakers
This brief examines potential challenges and opportunities for making health care reform work for children and youth, and describes some of the major implications of the ACA in regard to outreach, eligibility, coverage and access for children.

Keeping Children’s Coverage Strong in the Context of the Affordable Care Act: Perspectives from State Children’s Health Insurance Leaders
This brief highlights key considerations for children’s coverage that emerged from discussions with CHIP program directors soon after the passage of the ACA.


Celebrating 20 Years of CHIP and Looking Ahead
This webinar showcased the program’s successes by highlighting CHIP’s contributions to improving children’s coverage rates and featuring two state perspectives on the unique aspects of CHIP as well as the possible future role of the program in the changing health policy landscape.

Children’s Coverage Beyond CHIP: Policy Considerations for States
If federal CHIP funding is not extended beyond September 2017, children may need to transition to other sources of coverage in the future. This June 2015 webinar included perspectives from a national expert and officials from three different state health and insurance agencies to surface issues and questions about the future of children’s coverage.

Benefits and Cost Sharing in Separate CHIP Programs: Policy Implications in the Context of the ACA
This webinar features information from the Benefits and Cost Sharing report and presentations from both NASHP and CCF, as well as perspectives from Sharon Carte, West Virginia’s CHIP Director and a Medicaid and CHIP Payment and Access Commission (MACPAC) member.