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NEW YORK – Federal funding for a program to cover children lacking health insurance runs out in three months. Most states, even those experiencing funding shortfalls, are looking at various methods of expanding and reauthorizing the program.
Renewal of the State Children's Health Insurance Program, or SCHIP, has been hotly debated as lawmakers grapple with eligibility requirements, funding levels and the formula used to determine federal funding within each state.
Some 29 states and the District of Columbia have either adopted or are seriously considering new proposals to expand their individual SCHIP plans and improve children's healthcare coverage, a report by the Commonwealth Fund found.
Many of those proposals would expand eligibility levels by raising the percentage of the federal poverty level at which families would qualify for coverage, authors of the report noted. For example, New York's proposal would make SCHIP available to all residents making as much as 400 percent of the poverty level. Gov. Eliot Spitzer (D-N.Y.) estimates that the expansion will include almost all of the state's 400,000 uninsured children.
On May 25, President Bush signed into law $650 million in emergency funding for SCHIP, as 14 states stand to experience SCHIP funding shortfalls this year. According to the 10-year-old program's baseline funding, $5 billion will be allocated within the federal budget. States with shortfalls will get shares of an additional $4.8 billion.
Some states, including California, Illinois and Pennsylvania, are using SCHIP to spur universal coverage, the authors of the report said. In some cases, this involves introducing similar programs to provide coverage for uninsured low-income adults.
In deciding the federal government's continued level of involvement in SCHIP, legislators will consider a number of reauthorization issues, the report said. Such issues include:
- deciding who can be covered by SCHIP
- determining whether efforts to simplify enrollment and increase outreach should be supported at the federal level
- setting the level and types of coverage that should be offered under SCHIP
- undertaking efforts to promote quality care, best practices and evidence-based research.

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