Urban Institute report on SCHIP
Coverage Patterns Among SCHIP-Eligible Children and Their Parents
By Genevieve M. Kenney and Allison Cook
Urban Institute
February 9, 2007
SCHIP was enacted in 1997 to expand health insurance coverage to low-income uninsured children. Under SCHIP, states could use enhanced federal matching dollars to expand public coverage for children beyond Medicaid eligibility levels.
This study finds that most SCHIP enrollees do not have access to employer-sponsored insurance through their parents.
In addition, our analysis indicates that just 25 percent of all SCHIP enrollees live in families where one parent (in single-parent families) or both parents (in two-parent families) have employer coverage.
Following the implementation of eligibility expansions under SCHIP and the significant investments in outreach and enrollment simplification under both Medicaid and SCHIP, uninsurance rates have fallen for low-income children. Coverage gains have slowed, however, and the most recent CPS even indicated that uninsurance may be on the rise for children.
This brief has three important implications for SCHIP as it faces reauthorization. First, federal funding will have to be increased substantially if the allotments are to include coverage for the close to 2 million uninsured children who are eligible for SCHIP but not yet enrolled. Second, many children stand to lose coverage altogether if federal funds are inadequate to meet existing program need. Finally, addressing the insurance coverage needs of low-income parents through SCHIP would likely improve the lives of both low-income children and their parents but would require a substantial expansion in the federal funding commitment to the program.
http://www.urban.org/publications/311420.html
Full report: http://www.urban.org/UploadedPDF/311420_Coverage_Patterns.pdf
And…
HHS Proposes Nearly $700 Billion Budget for Fiscal Year 2008
U.S. Department of Health & Human Services
February 5, 2007
The President’s budget proposes to reauthorize State Children’s Health Insurance Program (SCHIP) for five more years, to increase the program’s allotments by $5 billion over that time, and to target SCHIP funds more efficiently to those most in need.
http://www.hhs.gov/news/press/2007pres/20070205.html
Comment:
By Don McCanne, MD
The State Children’s Health Insurance Program (SCHIP) continues to fall far short of its goal to insure all lower-income children who qualify. The fact that uninsurance in children is on the rise again suggests that the SCHIP program may have reached its fully predictable steady state in which attrition in enrollment offsets new gains.
An increase in outreach and enrollment efforts might be able to slightly shift the steady state threshold, but it can never be effective in enrolling all eligible children and keeping them enrolled.
Nevertheless, current efforts at reform are targeted to expanding the coverage of children, and perhaps even their uninsured parents. At a minimum, there does seem to be a consensus that the SCHIP program does need to be reauthorized this year, or it will be terminated.
What does the Bush administration propose? No funds for expansion of eligibility, inadequate funds to maintain even the deficient current level of enrollment, and, most ominously, targeting SCHIP funds “more efficiently to those most in need.” What does that mean? In testimony before Congress this week, HHS Secretary Michael Leavitt explained that existing state expansions of SCHIP eligibility would no longer be partially funded by the federal government because it is more important to apply those funds to the budget deficit.
The 2 million children currently eligible for SCHIP but not enrolled are only one-fifth of the uninsured children in the United States. While ignoring the other four-fifths of the children plus everyone else without insurance, the politicians are entering a debate to show which of them are the least heartless in their efforts to salvage, in a somewhat tattered state, this program that falls so far short of our goals to remove financial barriers to health care.
SCHIP does need to be reauthorized, but only as an urgent stopgap measure while we move forward briskly toward reform that would automatically enroll absolutely everyone in a comprehensive national health insurance program. But if the past few decades are any indication, we can anticipate the celebration of the reauthorization of SCHIP, and then… nothing further. That would be heartless.