Public insurance programs serve as crucial safety nets for children and families across the country, providing free or low-cost health coverage to millions of Americans and giving families access to essential preventive services and healthcare.
Medicaid is the single largest healthcare insurer for children, covering approximately 30 million kids, including over 40 percent of CHOP’s patients. Children covered by Medicaid represent about half of all Medicaid enrollees, though only a quarter of its costs. The program, which has basic benefit requirements, including preventive care such as health screenings and immunizations, also covers eligible low-income adults, pregnant women, and people with disabilities.
Medicaid is administered by states, which must follow federal program requirements, and is jointly funded by states and the federal government. Notably, due to increased federal funds available through the Affordable Care Act, more than half of all states, including Pennsylvania, have chosen to expand their Medicaid programs in recent years to cover all individuals below certain income levels.
Children’s Health Insurance Program
The Children’s Health Insurance Program (CHIP), another state-federal program, provides low-cost health insurance to children in families that earn too much money to qualify for Medicaid. CHIP provides another important layer of coverage for vulnerable children and families across the country. In some states, CHIP also covers pregnant women.
CHIP was originally created by the Balanced Budget Act of 1997, which was reauthorized in 2009, 2013 (through the Affordable Care Act) and 2015. At the end of September 2017, the program expired. For the time being, kids are still getting coverage as states have money left over from the last federal government payment installment. However, in the coming months, states will begin to run out of reserves, and congressional action is required again for CHIP to continue to provide coverage for kids.
Update: In early October 2017, the U.S. House and Senate held hearings on bills to extend the program for another five years. This is good news, but only a first step in the process. Please contact your senators and representatives to ask them to act quickly to bring these bills to a vote.
Learn more about Pennsylvania CHIP and New Jersey CHIP.
Supplemental Security Income (SSI) for Children
The Supplemental Security Income (SSI) program provides financial support to low-income families of children with special healthcare needs and disabilities. In most states, including Pennsylvania and New Jersey, when a child qualifies for SSI based on a disability, they also qualify for the state Medicaid program, providing healthcare services as well. This program is yet another safety net for many children with complex, chronic conditions.
How you can help
As we continue our efforts to preserve Medicaid coverage for children and families and as Congress debates extending CHIP, you can help CHOP advocate for both programs. Contact your elected officials directly through the Children Hospital Association’s Speak Now for Kids campaign or simply send your representative your own personal email message via the Congressional website.
Read more about covering children with serious chronic health conditions for additional information on Medicaid’s value to children.
To learn more about these programs and their importance to CHOP patients and families, contact our Government Affairs team.