The State Children's Health Insurance Program (SCHIP) is a program that provides health insurance subsidies for children who do not qualify for Medicaid but their parents cannot afford private health insurance. It was created in the Balanced Budget Act of 1997, which is also referred to as Title XXI. The program is targeted to low income families with incomes 200 percent of the poverty level or lower and children under the age of 19.
SCHIP is a federally program but is administered at the state level. The state governments pay for the program through an enhanced match system of allotted funds from the federal government. Each state has three years to spend their allotment and after that time any left over money is reallocated to states that have shortfalls.
How the program is administered varies by state. Some states use a Medicaid expansion program, where SCHIP money is handed out according to the rules and regulations of Medicaid but with expanded coverage of older children and those that do not qualify for Medicaid. Other states create a separate plan for SCHIP that is administered more like private health insurance plans. SCHIP in Michigan, also known as MIChild, is ordered as a combination of the two. Regardless of the management system, inpatient, outpatient, emergency, and some specialists, as well as well-baby, well-child and immunization visits are required coverage in every state.
Eligibility also varies by states. Some states have received waivers to cover adults related to children that are covered under SCHIP. Also, some states cover children of people who make more than 200 percent the poverty level, while limit coverage to 175 or 185 percent. Georgia for instance received a federal waiver to cover people making less than 235 percent the poverty level.
As of 2006, 4.4 Million children were covered under the program, 56,195 of that number from Michigan. Michigan's MIChild receives a 69.47 percent match from the federal government for services and covers older children at 185 percent the poverty level and infants at 200 percent the poverty level. As of 2006 Michigan was not one of the Shortfall States, or a state that runs out of their yearly allotment. However, due to economic problems, rising levels of enrollment, and the ballooning costs of health care, more states are starting to run out of money. In 2008, the combined shortfall for all 50 states was $1.1 billion.
The program was up for reauthorization in the fall of 2007 and many in congress were seeking to expand the reach of the program to cover those making less than 300 percent the poverty level, among other things. President Bush vetoed the legislation two times before eventually signing a bill that extended the funding through March 2009, without expanding its reach.
1- National Conference of State Legislatures "Frequently Asked Questions... SCHIP" http://www.ncsl.org/print/health/forum/SCHIPFAQ.pdf
2- National Conference of State Legislatures "SCHIP Reauthorization Resources" http://www.ncsl.org/programs/health/chiphome.htm
3- Michigan Department of Community Health FAQ http://www.michigan.gov/mdch/0,1607,7-132-2943_4845_4931-20641--,00.html#eligibility