Children's Health Care Insurance



Children's Health Care Insurance

Introduction

Lack of health insurance coverage is a problem for many persons who live in the United States, a country without a universal health care plan. Uninsured persons have no guarantee of receiving even the most basic health care services.. In an effort to provide access to health care for children in low income families, the government formed the State Children's Health Insurance Program (CHIP). Section 4901 of the Balanced Budget Act of 1997 amended the Social Security Act to create the State Children's Health Insurance Program (CHIP) as Title XXI of the Social Security Act (Martin, 2000). The South Carolina Department of Health and Human Services is responsible for administering the state CHIP program called Partners for Healthy Children (PHC). South Carolina integrates the federal funds it receives to pay for uninsured children into its Medicaid program to increase the level of coverage provided. This arrangement is called a Medicaid expansion program. Services are provided to children 18 years of age and younger who live in households in which the income is at or below 150 percent of the federally defined poverty level, and who meet other nonfinancial requirements such as being residents of the state and United States citizens.

Another recent study found that the potential savings from reducing CHIP are smaller than expected because children denied participation. in CHIP would cause offsetting increases in other areas of federal and state budgets through uninsured ED visits that are paid for with public funds. Also, a study assessing the health status of children revealed that improved access to care and increased use of its children's health insurance program had a positive effect on the health of the children. In studying parental views regarding the effect of insurance programs such as CHIP in relation to meeting the mental health needs of children, it was discovered that children enrolled in such programs were less likely to report unmet mental health needs than children covered by private health insurance (Marchione, 1994).

State Children's Health Insurance Program

The State Children's Health Insurance Program (CHIP) was developed to assist uninsured low income children who are not eligible for Medicaid in gaining healthcare coverage. By law, a State Children's Health Insurance Program must provide at minimum: age appropriate immunizations, well-baby, laboratory, and x-ray services: inpatient and outpatient hospital services; physician surgical and medical services; and well-child services. When CHIP was first implemented in 1997, policymakers had little information regarding what issues or problems to expect, such as enrollment verification problems, how to handle cost-overruns, and how to measure if recipients were receiving high quality care. Additionally, specific goals for program evaluation had not been established. It was not until after CHIP implementation that some of the issues were discovered. For example, in 1999 the National Survey of America's Families reported that children who enrolled in CHIP had greater health services needs than children with other forms of medical coverage. Ensuring that eligible children were enrolled was another issue CHIP encountered as ...