Children’s Health Care Reform

The Children's Health Insurance Program (CHIP) is a program offered by the United States Department of Health and Human Services that helps families afford health insurance for children (Hood, 2014). It is primarily for families who financially fall between the inability to afford private insurance, and yet still have annual incomes above the cutoff point for Medicaid (Paradise, 2014). The initial bill was written in 1993 by President Bill Clinton and enacted by congress in 1997. Senator Ted Kennedy wrote most of the bill, which increased tobacco taxes by 43 cents per pack to raise the $20 billion needed to fund the program (2014).

President Bush vetoed an attempt to expand funding for CHIP in 2008, stating that he wanted to avoid the federalization of health care, and that expanding it would steer the program away from its core purpose of providing insurance for poor children and toward covering children from middle-class families (Racine, 2014, p. 784). President Obama expanded the program to children of immigrants in 2009 and ended the mandatory wait time until they could be insured, which allowed access to an additional four million children (2014). In January of 2018, President Trump signed legislation that continued CHIP until 2024, and then in February 2018 Congress passed the Bipartisan Budget Act, which extended CHIP until the year 2027 (Paradise, 2014).

The program has been a widespread success, as it increased to cover 7.6 million children in 2010 (Rancine, 2014). Today, 45 million children are enrolled in the CHIP program, which represents 45% of all children under the age of six, and 35% of children ages seven to 18 (2014). Despite this, some children remain uninsured for various reasons. Although it is not illegal to not have health care insurance for a child in the United States, under the Affordable Care Act, there are fines that may be imposed of $695 per person and $347.50 per child, per year, up to $2085 per family annually for not having health insurance (Paradise, 2014). These fines are assessed through federal income tax, unless a person is exempt. The exceptions include the fact that the person makes less than the minimum cutoff requirement to pay income taxes, was evicted, bankrupt, has religious objections to health care, was in jail, or was an immigrant who was not in the country legally, all in the previous year (2014). Additionally, the program continually faces financial inadequacies in various states (2014).

Each state has different eligibility requirements for CHIP. In Ohio, for example, children up to age 18 whose families make more money than the Medicaid cutoff but up to 200% of the poverty level may qualify for CHIP. In 2018 the poverty level in Ohio for a family of four is $25,100 per year, so the CHIP eligibility requirement would be less than $50,200 per year (Ohio, 2018). Other states are more restrictive or permissive with their numbers according to their individual budgets. Most states have a requirement that a family cannot make twice the federal level of poverty, which is currently $25,100 per year for a family of four. Some exceptions include North Dakota, which allows up to 170% and New York, which allows families to make 400% of the poverty level and still qualify for CHIP (Racine, 2014). These differences are due to the various costs of living in each state.

Today Medicaid and CHIP cover the healthcare needs of more than one in every three children under the age of 18 in the United States (Paradise, 2014). CHIP provides a cushion for children during economic difficult times, or if one or more parents lose their employment and subsequent health care plans. It has a dental aspect, which is unusual for most private health insurance companies (Racine, 2014). CHIP is also inclusive of children with special needs, insuring treatments such as speech therapy, occupational therapy, and physical therapies required by differently-abled kids (Paradise, 2014). It is not difficult for the parents of children on CHIP to find access to medical care, however research shows that children covered by CHIP visit the emergency room more often than children with private insurance (2014). Overall, Medicaid and CHIP expansion have had positive effects on the availability of healthcare to children in the United States (2014). This increases the ability of the children to perform well at school, gain a good education, and have a positive impact on their own economic status later on in life, as well as the economy of our society as a whole.

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