Children's Health Insurance Program CHIP

The Children's Health Insurance Program was created by the Balanced Budget Act of 1997, signed August 5, 1997, after a bipartisan push led by Senators Ted Kennedy and Orrin Hatch. It covers children, and in some states pregnant women, in families with incomes above Medicaid limits, often up to 200 to 300 percent of the poverty line. About 7 million children are enrolled at some point each year.

States may run CHIP as part of Medicaid, as a separate program, or as a mix, and the federal government pays a higher share than it does for Medicaid, typically 65 to 85 percent. Separate state programs may charge small premiums and copays. Together Medicaid and CHIP cover more than a third of American children, and the share of uninsured children fell from about 14 percent in 1997 to about 5 percent in recent years.

Unlike Medicaid, CHIP is funded by Congress for set periods, and its funding lapsed briefly in 2017 before Congress extended it in 2018 through fiscal 2027, so another extension is due by September 30, 2027. Support has been broadly bipartisan, though Congress has debated income limits, how much to fund, and whether to cover immigrant children and pregnant women.