Children's Health Insurance Program ( CHIP ) - formerly known as Country Child Health Insurance ( SCHIP ) - is a program administered by the United States Department of Health and Human Services that provides funds suitable for states for health insurance for families with children. The program is designed to include uninsured children in families with modest but high incomes to qualify for Medicaid.
The program came in response to the failure of comprehensive health care reforms proposed in 1993 by President Bill Clinton. The legislation to create was sponsored by Senator Ted Kennedy in partnership with Senator Orrin Hatch, with the support of First Lady Hillary Clinton during the Clinton administration. In its creation in 1997, SCHIP is the largest expansion of health insurance coverage financed by taxpayers for children in the US since Lyndon Johnson founded Medicaid in 1965. The legal authority for CHIP is under the heading XXI of the Social Security Act.
Countries are given flexibility in designing the terms and policies of their eligible CHIP in broad federal guidelines. Some countries have accepted the authority through the waiver of legal provisions to use CHIP funds to protect parents of children who receive benefits both from CHIP and Medicaid, pregnant women and other adults. CHIP includes 7.6 million children during the 2010 federal fiscal year, and each state has an approved plan. Although CHIP, the number of uninsured children continues to increase, especially among families who are not eligible for CHIP. A study in October 2007 by the Vimo Research Group found that 68.7 percent of newly insured children were in families whose income reached 200 percent of federal or higher poverty rates because more employers were imposing dependents or losing coverage altogether due to premiums yearly almost doubled between 2000 and 2006. Vimo quoted the Kaiser Commission on Medicaid and The Incinsured when saying 48 percent of the new insured did not qualify for any kind of public coverage, and that only those in the lowest income group might be offset loss of company-sponsored coverage with improved Medicaid and SCHIP. In FY 2008, the program faced funding shortfalls in several states.
Two attempts to expand funding for the program were voiced by President George W. Bush, who argued that such efforts are steps towards federalization of health care, and would "keep the program from its sole purpose of providing insurance for poor children and to cover children "On February 4, 2009, President Barack Obama signed the Children's Health Insurance Reauthorization Act of 2009, expanding the health care program to an additional 4 million children and pregnant women, including" law-abiding "immigrants without waiting period.
A 2018 survey of existing research noted that the availability of "CHIP coverage for children has led to improved access to health care and improved health in both the short and long term."
Video Children's Health Insurance Program
History
The Children's Health Insurance Program grew from years of work in the US Congress to improve the health coverage of Americans. Almost a decade earlier, the US Bipartisan Commission on Comprehensive Health Care was formed in 1989 and charged with recommending "legislative action to ensure coverage for all Americans." The Commission, renamed the Pepper Commission in honor of its creator and first chair Representative Claude Pepper (D-Fla.), Laid out a blueprint for achieving universal coverage. Given the challenges of comprehensive health reform, Governor Jay Rockefeller, who was elected president after the death of Rep. Pepper, emphasizes its commitment to pursue legislative action not only on the commission's complete recommendations but also on "down payment" - to expand the immediate public health coverage for children and pregnant women, consistent with the commission's proposed principles. The law will ensure the coverage of public insurance through Medicaid for every American child living in poverty and offsetting the cost of repairs by doubling the federal excise tax on cigarettes.
Immediately following his election in 1992, President Bill Clinton assembled a task force to write a comprehensive health reform bill, and he worked with Congress to introduce the Health Safety Act (HSA) in November 1993. This included provisions such as universal coverage and packet base benefits, health insurance reform, and consumer choice for health plans.
After the HSA failed in the fall of 1994, congressional and government leaders recognized the need for a gradual bipartisan approach to health care reform. Senator Jay Rockefeller continues to argue to expand coverage for children. He referred to amendments to accelerated coverage children and pregnant women offered during the Senate Senate health care markup reform adopted by a bipartisan majority of 12 to 8 as evidence that there is bipartisan support to provide assistance to children. He also goes on to say expanding coverage for children is vital to reforming the welfare system to "prevent families from having to go and get out of welfare to qualify for Medicaid."
The 1996 Bipartisan Budget Agreement made a net reduction in federal Medicaid spending over a five-year period but anticipated an additional $ 16 billion in expenditures for the health care of children during the same period. However, it does not provide details of how the money will be spent. In 1997, several members of Congress introduced bills to cover uninsured children using $ 16 billion, and two of the most popular proposals were Chafee-Rockefeller proposals and Kennedy-Hatch proposals.
Senator Ted Kennedy, Chair of the Health, Education, Employment and Retirement Senate Committee (HELP) was interested in the children's health insurance plan in Massachusetts that graduated in 1996, and met with the director of the pediatric Boston Medical Center and a Massachusetts state legislator to discusses the feasibility of national initiatives. Kennedy also saw using tobacco tax increases as a way to pay for expanded coverage. Thus, in October 1996, Kennedy introduced a bill to provide health care coverage for children of working poor, who would be financed through 75 cigarette taxes.
Kennedy took the Republican Senator Orrin Hatch to the law as a co-sponsor. Kennedy and Hatch had worked together as "weird couples" in the previous Senate, and here Hatch said that "Children are deeply hurt and may be hurt for the rest of their lives" and that "as a nation, as a society, we have moral responsibility "to provide coverage. Hatch's role will upset some Republican colleagues and conservative commentators.
On April 8, 1997, Senators Kennedy and Hatch introduced S. 525, the Child Health Insurance and Deficit Deficit Act (CHILD).This law changed the Public Health Service Act to create a new grant program for countries to purchase private health insurance for children were proposed to collect $ 30 billion over 5 years by raising tobacco taxes with $ 20 billion to be extended to children under a block grant approach and $ 10 billion for deficit reduction.SS525 was referred to the Labor and Employment Education Senate HELP) Committee The hearing was held in the Bill within the ASSISTANCE Committee but the law to expand coverage for children has never been followed up on the HELP Committee.
On April 30, 1997, Sen. John Chafee (R-RI) and Jay Rockefeller (D-WVa.) Introduced S. 674, a bill to amend the XIX title of the Social Security Act "to expand the health coverage of low-income children and pregnant women and provide funding to promote outreach efforts to register eligible children. "On the same day, John Dingell (D-MI) Representative introduced identical bipartisan companions' bills in the House of Representatives with Republican sponsors, Representative Margaret Scafati Roukema (R-NJ).
Meanwhile, in December 1996, First Madame Hillary Rodham Clinton examined several possible initiatives and decided to expand health care insurance for children who have nothing to advance, especially as the focus on children will become politically popular. This is a precedent from the previous Clinton administration: a different variant of this approach, dubbed "First Child", was envisaged as a backup plan during the original 1993 Task Force at the National Healthcare Reform meeting. In addition, Hillary Clinton has discussed programs such as SCHIP with the White House's health policy coordinator as long as her full health care plan has suffered a political failure.
The new initiative was proposed at Bill Clinton's State of the Union address in January 1997, targeting up to five million children. Kennedy continues to write much of the bill, using an increase in tobacco taxes to pay the $ 20 billion price tag. In March 1997, Kennedy brought Republican Senator Orrin Hatch into law as a co-sponsor; Kennedy and Hatch had worked together as "weird couples" in the previous Senate, and here Hatch said that "Children are deeply hurt and may be hurt for the rest of their lives" and that "as a nation, as a society, we have moral responsibility "to provide coverage. Hatch's role will upset some Republican colleagues and conservative commentators. The First Lady did not hold a press conference or testify before Congress on behalf of the bill.
The Senate's early objection to the Senate is that it proposes to pay for services by raising federal taxes on cigarettes, from 24 cents per packet to 67 cents per packet, ignoring the possible consequences that tobacco product sales will decrease and tax revenues will be farther away than required to pay for expansion of benefits. Kennedy and Hatch scoffed at the objection, saying, "If we can make healthy people and stop them from dying, I think most Americans will say 'Amen; is not that a good result?' If fewer people smoke, the state will save far less on healthcare costs than they would lose income from tobacco taxes. "The Republican Party also criticized the bill as an open rights program, though it was structured as a block grant rather than a right; Senate Majority Leader Trent Lott is an early opponent of the move, calling it a "big government program" that will not pass.
So the bill must comply with the existing balanced budget agreement between the Congress and the White House, something Lott said did not. Pressure to reduce the number of grants involved, with $ 16 billion possible compromise; Hillary Clinton instead argued for $ 24 billion. The Clinton administration has an agreement with the Republican leadership in Congress that prohibits the government from supporting any changes to the budget resolution. Thus, Bill Clinton phoned members of Congress and demanded that they kill the provision of children's health insurance when it reached the floor. On May 22, it was done, with the required cigarette tax amendment defeated by 55-45 margin. Hillary Clinton defended her husband's actions at the time, saying "She has to keep the overall budget proposal," but Kennedy is shocked and outraged by it, dismissing her as a betrayal, and says that her call to Bill Clinton and Vice President Al Gore has not been returned. Hatch is also upset, saying that Lott may have been bluffing and that, "I think the President and the people at the White House are giving up here."
Kennedy did not give up on the move, saying: "We will offer it again and again until we win.This is more important to protect children than to protect the tobacco industry." Both Bill and Hillary Clinton are of the opinion to include child health insurance in subsequent legislation. The bill was indeed revived by Kennedy and Hatch a month after the initial defeat. Organizations from the Children's Defense Fund to the Girl Scouts Girl United States lobby for his trip, putting public pressure on Congress; Hillary Clinton encouraged her too, with Kennedy urging her to use her influence inside the White House. SCHIP was then passed and signed into law by Bill Clinton on 5 August 1997 as part of the Balanced Budget Act of 1997, to take effect the following month. At a press conference after the signing, Kennedy thanked Hatch, Senate Minority Leader Tom Daschle, head of the Children Defense Fund Marian Wright Edelman, Bill Clinton, and Hillary Clinton. About the latter, Kennedy said, "Mrs. Clinton... is an invaluable aid, both in the formation and formation of the program and also as a clear supporter."
SCHIP is located in Title IV, subtitle J of H.R. 2015 [105th] Balanced Budget Act of 1997. H.R. 2015 was introduced and sponsored by Rep. John Kasich [R-OH] without cosponsors. On June 25, 1997, H.R. 2015 passed House Vote Roll # 241 mainly between the partisan lines, 270 ayes and 162 no, with most Democrats in the House opposing. On the same day, the bill was passed in the Senate, with a substitute amendment, with unanimous consent. After the conference between the House and the Senate, the sections in both House (Roll # 345: 346-85) and Senate (Roll # 209: 85-15) at the alternate conference became more bipartisan.
Maps Children's Health Insurance Program
Country administration
Like Medicaid, SCHIP is a partnership between the federal and state governments. Programs are run by each country according to the requirements set by the federal Center for Medicare and Medicaid Services. Countries can design their SCHIP program as an independent program separate from Medicaid (a separate child health program), using SCHIP funds to expand their Medicaid program (Medicaid SCHIP expansion program), or incorporate this approach (SCHIP combination program). Countries receive enhanced federal funds for their SCHIP program at levels above regular Medicaid matches.
By February 1999, 47 countries had organized the SCHIP program, but needed to register children. That month, the Clinton administration launched the "Insure Kids Now" campaign, designed to get more children enrolled; the campaign will be under the protection of the Resource Administration and Health Services. In April 1999, about 1 million children were registered, and the Clinton administration set the goal of raising the figure to 2.5 million in 2000.
Countries with separate child health programs follow the rules outlined in Section 42 of the Federal Regulatory Code, Section 457. Separate child health programs have much greater flexibility than Medicaid programs. Separate programs can impose cost sharing, customize their benefit package, and use a lot of flexibility in terms of eligibility and registration. These flexibility limits are described in the rules, and countries should describe the characteristics of their programs in their SCHIP country plans. Of the 50 state governors, 43 support the extension of SCHIP. Some countries have incorporated the use of private companies to manage some of their SCHIP benefits. These programs, commonly referred to as Medicaid-administered care, allow private insurance companies or health care organizations to contract directly with the country's Medicaid department at a fixed price per enrollee. The health plan then enrolls the qualified individual into their program and becomes responsible for ensuring the SCHIP benefits are sent to qualified recipients.
In Ohio, SCHIP funds are used to extend eligibility for the country's Medicaid program. Thus all Medicaid rules and regulations (including sharing of fees and benefits) apply. Children from birth to age 18 living in families with incomes above the Medicaid threshold in 1996 and up to 200% of federal poverty qualified for the Medicaid SCHIP expansion program. In 2008, the maximum annual income required for a family of four fell within 100% of federal poverty guidelines was $ 21,200, while 200% of the poverty guidelines were $ 42,400.
Other countries have similar SCHIP guidelines, with some countries being more generous or limiting the number of children they allow into the program. With the exception of Alaska, Idaho, North Dakota and Oklahoma, all countries have a minimum threshold for coverage on 200% of federal poverty guidelines. North Dakota currently has the lowest at 175%. New York currently has the highest in 405% of federal poverty guidelines. The Medicaid SCHIP expansion program typically uses the same name for Medicaid expansion and programs. Separate child health programs usually have different names for their programs. Some states also refer to the SCHIP program with the term "Child Health Insurance Program" (CHIP).
Countries are permitted to use Medicaid and SCHIP funds for premium assistance programs that help qualified individuals to purchase private health insurance. In 2008 relatively few states had a premium assistance program, and registration was relatively low. However, interest in this approach remains high.
In August 2007, the Bush Administration announced a regulation requiring states (in August 2008) to enroll 95% of families with children get 200% of the federal poverty rate, before using the funds to serve families who earn more than 250% of poverty federal. The federal government says that 9 out of 17 states offering benefits to higher-income families are obedient. Opponents of this rule argue that registering higher-income families makes low-income families more likely to enroll, and that the regulation is not fair to children who will go without health insurance.
Implementations
- California: California Healthy Family Program
- Utah: State Children's Health Insurance Program in Utah
Impact
A 2018 survey of existing research noted that the availability of "CHIP coverage for children has led to improved access to health care and improved health in both the short and long term."
In 2007, researchers from Brigham Young University and Arizona State found that children who dropped SCHIP fees expressed more money because they shifted from routine care to more frequent emergency care situations. The conclusion of this study is that efforts to cut the cost of state health programs can create fraudulent savings as other government organizations take tabs for children who have lost insurance coverage and then need treatment.
In a 2007 analysis by the Congressional Budget Office, the investigators determined that "for every 100 children receiving coverage as a result of SCHIP, there is a corresponding reduction in personal coverage between 25 and 50 children." The CBO speculates this is because state programs offer better benefits at a lower cost to register than private alternatives. A short paper by the libertarian think tank, Cato Institute, estimates that the "crowding out" of private insurance companies by public programs can reach 60%.
SCHIP was created in 1997 as a ten-year program; to continue the 2007 federal fiscal year, a reauthorization law is required. The first two re-authorization charges to pass through Congress will also broaden the scope of the program; President George W. Bush vetoed them as an improper expansion. The two-year re-authorization law was signed into law by the President in December 2007 which will only extend the current SCHIP service without expanding part of the program. With the election of President and Congress 2008 giving Democratic control of the Oval Office as well as expanding the majority in both houses of Congress, SCHIP re-authorized and expanded in the same bill through fiscal year 2013.
HR 976
In 2007, the two Congressional assemblies issued bipartisan measures to expand the SCHIP program, HR 976. This measure will extend coverage to more than 4 million more participants by 2012, while gradually removing most of the country's expansion into programs that include adults other than women pregnant. The bill calls for a five-year budget increase of $ 35 billion, raising total SCHIP spending to $ 60 billion for a five-year period. The opposition to HR 976 focuses on raising $ 35 billion in government health insurance and $ 6.5 billion in Medicaid benefits to illegal immigrants. Originally intended to provide health care coverage to low-income children, HR 976 was criticized as a giveaway that would benefit both adults and non-US citizens. The expansion of the program is funded by federal excise taxes that are rising sharply on tobacco products. On the other hand, opponents say this proposed expansion for families with annual income of up to $ 82,600 (400 percent of federal poverty rates)
On 3 October 2007, President Bush vetoed the bill, stating that he believed it would "generalize health care", expanding the scope of SCHIP further than its original intent. Veto is the fourth of his government. After his veto, Bush said he was open to a compromise that would require more than $ 5 billion in originally budgeted, but would not approve proposals that drastically expand the number of children eligible for coverage.
On October 18, 2007, the House of Representatives lost 13 short votes (273-156) of the two-thirds majority needed to override the presidential veto, although 44 Republican members joined the 229 Democrats in favor of the move.
HR 3963
Within a week of veto failed to override votes, the House passed a second bill that tried the same extension of SCHIP. According to Democrats, the second bill, H.R. 3963, creates a stronger hat on income feasibility, prevents adults from joining, and prohibits children of illegal immigrants from receiving benefits. However, according to his opponents, this second proposed expansion is for families with annual revenues of up to $ 62,000 (300 percent of federal poverty rates). The Senate passed the pace on 1 November 2007, but on 12 December 2007, Bush vetoed the bill as well, saying it was "essentially identical" to the previous law, and the House vote in January 2008 failed to override the veto.
Pub.L. 110-173, which extended SCHIP funding until March 31, 2009, and the President signed it into law on December 21, 2007.
After the inauguration of President Barack Obama and the growing majority of Democrats in both houses of Congress, legislative leaders moved quickly to break the political deadlock over SCHIP expansion. On January 14, 2009, the DPR passed H.R. 2 with voting 290-138. The bill drains a budget and adds $ 32.8 billion to expand its health coverage program to include about 4 million more children, including legal immigrant coverage without a waiting period for the first time. Increase in cigarette taxes 62 cents - bring a total tax on a pack of cigarettes to $ 1.01 - an increase in taxes to chew tobacco from $ 0.195/lb. up to $ 0.50/lb.-- and tax increases on other tobacco products will fund the expansion of the program. On January 29, the Senate passed the House bill with a margin of 66-32, with two amendments. The House of Representatives received a revamped version of the 290-135 vote, and President Obama signed the bill into law as Pub.L. 111-3 on 4 February 2009.
2010 funding through Patient Protection and Affordable Care Act
Section 2010 and the signing of the Patient Protection and Affordable Care Act include funding for CHIP until 2015.
By 2015, Congress passes Medicare Access and the CHIP Reauthorization Act of 2015 (MACRA), and signed by President Obama.
CHIP expires on September 30, 2017. The state will have funds remaining to keep the program running for various time periods. On September 18, 2017, Senators Orrin Hatch and Ron Wyden introduced the Responsible and Responsible Act on Security Children Security (KIDS), S. 1827. The bill will fund CHIP for another five years, until 2022.
A separate bill has passed a bill called the CHAMPION Act H.R. 3922 in the US House of Representatives on November 3, 2017 and awaits Senate approval.
A six-year reauthorization of CHIP has been signed into law by President Trump on January 22, 2018. The 1959 Bill on HR (known as the Federal Register Registration Printing Act of 2017, including the Renewal of Licensing Act 2018) was passed by Parliament, with a voice of 266-150, and by the Senate, in a voice of 81-18. 144 House Democrats and 15 Democratic Senate voted against the bill to reauthorize CHIP, as the congressman objected to ending a three-day government shutdown without legally perpetuating the DACA program for undocumented immigrants.
On February 9, 2018, the United States Congress decided to extend the CHIP for an additional 4 more years, above the current 6 year extension, as part of the 2018 Bipartisan Budget Act with a 71-28 vote in the Senate and by voting 240-186 at House of Representatives. President Trump signed the budget law into law shortly thereafter, allowing the extension of CHIP until 2027.
See also
- Cigarette tax in the United States
- Graeme Frost
- Health insurance in the United States
- PeachCare
- TexCare
References
External links
- CHIP at Medicare & amp; Medicaid Services
- United States Social Security Administration
- Georgetown University Children and Family Resource Center at SCHIP
Source of the article : Wikipedia
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