Forum Session

The State Children's Health Insurance Program: How Much Latitude Do the States Really Have?
October 1, 1998


Richard Hegner


The State Children's Health Insurance Program (CHIP) — a major program to cover low-income, uninsured children — was passed as part of the Balanced Budget Act of 1997. Its passage was part of a trend of a shifting balance of power between the federal and state governments, particularly in the policy areas of health and social welfare. This Forum meeting explored the degree of freedom afforded the states by CHIP, the factors guiding state decision making and planning, and the factors influencing the states' various decisions about CHIP. The discussion focused on state options in four basic areas: participation or nonparticipation in CHIP; expansion of state Medicaid programs versus development or enlargement of separate state programs for uninsured children, using CHIP funding allotments; the levels at which eligibility levels are set; and ways to contain crowd-out.


Debbie I. Chang, Co-chair, Steering Committee on CHIP Implementation, and Director, Division of Benefits, Coverage, and Payments, Center for State Operations, Health Care Financing Administration; HHS; Barbara Ladon, Director, Office of Program Development, Colorado Department of Health Care Policy and Financing; Sandra Shewry, Executive Director, California Managed Risk Medical Insurance Board; Greg Vadner, Director, Division of Medical Services, Missouri Department of Social Services; Gwendolyn Williams, Commissioner, Alabama Medical Agency

Related Materials

More information available in the accompanying publication, Issue Brief No. 725.

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