State Children’s Health Insurance Program (SCHIP)

Fundamental Purposes of SCHIP

While assessing from many angles, the SCHIP should be considered as a successful program in achieving the fundamental purposes for which the program was formulated. The program has enabled millions of children to have access to healthcare, which they would not have otherwise availed. SCHIP has also changed the process relating to the application of Medicaid. This has resulted in greater participation in the Medicaid programs. The combination of generous federal matching rates has ensured the success of SCHIP. There are other factors like the latitude of states over their programs and the budget surpluses that resulted in the states at the point of time when SCHIP was introduced which also contributed to achieving the fundamental purposes of the program. The strong bipartisan support in favor of providing health insurance to more children was also another reason for the success of the program (Kenney & Change, 2004).

However, there are certain shortcomings of the program, which have impeded its further expansion. Since SCHIP made the existing insurance system complicated result there were new inequities in accessing healthcare within as well as across the states. There are cases where some children remained uninsured despite having the eligibility to get the benefits under SCHIP. This status is in spite of the fall in the uninsured rates for children. The phenomenon of retrenchment in the Medicaid and SCHIP happening in a number of states increases the doubts about the program being expanded in the future covering children belonging to a lower-income group (Dubay & Kenney). Despite the shortcomings, on an overall assessment, it can reasonably be stated that SCHIP has achieved its fundamental purposes to some extent.

Future Expansion of SCHIP

The likely shortfalls in the federal funding will make more states look into the way of SCHIP for providing healthcare facilities to the children. However, there is additional time required to assess the consequences of SCHIP being offered as an optional coverage and the consequences in view of the fact that the enrollees of SCHIP are in programs that are not the ones providing for individual entitlement. Ultimately, it may become critically important for the government to make a complete assessment of the extent to which incremental coverage expansions are optional requiring state funds. This assessment and decision on the expansion of the program to cover more children would depend largely on the assessment of the consequences of the programs already instituted. Therefore, the government has to wait for taking a decision in the direction of expanding the SCHIP programs to cover broader health care needs of children. There are other issues, which need the consideration of the policymakers to move further in expanding the SCHIP programs (Kenney & Change, 2004). The financing of the SCHIP, the relationship between SCHIP coverage for children and Medicaid and defining the roles of federal and state governments in funding as well as shaping the Medicaid and SCHIP for children and the families are some of the issues that need consideration before the government can take any decision on the expansion of SCHIP. The question of extending SCHIP to cover the parents in addition to children is another issue, which shakes the fundamental purposes for which SCHIP was introduced. The government has to firm up its policies on this issue before it could decide on the expansion of SCHIP.


  1. Dubay, L., & Kenney, G. (n.d.). Gains in Children’s Health Insurance Coverage, But further Progress Needed. Pediatrics , Forthcoming.
  2. Kenney, G., & Change, D. (2004). The State Children’s Health Insurance Program. Health Affairs , 23 (5).
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