Policy Priorities

Policy Priorities image of kids

Let's Build on What Works: Keep CHIP and Make it Better!

all children, all care, everywhere

The House bill, the Affordable Health Care for Americans Act of 2009 (H.R.3962), repeals the Children's Health Insurance Program (CHIP) in 2013 and would move millions of children into a new, untested and far more expensive Health Insurance Exchange where parents would end up paying significantly more for fewer benefits for their children. The President has said that health reform ought to build on what works—so rather than dismantle a program that has proven successful in providing affordable health coverage to millions of children, let’s keep CHIP (as the Senate Finance Committee bill does) until it can be replaced with a system that guarantees comparable or better benefits and caps on out-of-pocket costs for families. No child should be worse off after health reform than they are now.

Keeping CHIP is cost-effective for children, families and for taxpayers.

  • According to Congressional Budget Office Director Doug Elmendorf, covering children in CHIP costs taxpayers far less that covering them in the exchange and will keep more children from being uninsured.
  • A recent study by Watson Wyatt Worldwide for First Focus comparing the affordability of CHIP to coverage for children in the exchange plans in both the House and Senate proposals found that, depending on family income, families with children enrolled in CHIP are only responsible for 0–2 percent of their child’s medical expenses compared to the exchange plans that would require families to pay anywhere from 5–35 percent of the cost. Moving children into the exchange from CHIP would leave millions of low-income children worse off―paying more for fewer benefits.
  • By keeping CHIP, the Senate Finance Committee bill saved tens of billions of dollars in funds that should be invested in making children’s health coverage better.

Real child health reform must not only keep CHIP, but improve it.

Improving a program that we know works is a better and more cost-effective way to ensure children have the effective national health safety net they so desperately need today! To work for children, the Senate health reform bill—and then final health reform legislation—must include a comprehensive, affordable and accessible child health system that serves children wherever they live. The bill must:

  • End the bureaucratic barriers in Medicaid and CHIP that now keep 2 out of 3 of the more than 8 million uninsured children who are already eligible from actually getting the care they need. Older Americans are automatically covered by Medicare; children also need a simple, seamless enrollment process to assure they can get health coverage and keep it.
  • Guarantee every child access to the full range of health and mental health benefits they need including preventive and specialized services now provided to all children in Medicaid, but to only some children in CHIP. All children’s lives are of equal value.
  • Ensure children affordable coverage no matter what state they live in. By ensuring all states provide an affordable national health safety net for children with a family income below 300 percent of the federal poverty level ($66,000 for a family of four), we eliminate the unjust “lottery of geography.” Twenty-two states and the District of Columbia have already reached this goal of covering children up to 300 percent of poverty; two exceed this goal. No child should have to pay more for less coverage after health reform.

After more than three decades of work by the Children’s Defense Fund and many partners to ensure all children a healthy start in life and the chance to reach productive adulthood on a level playing field, much incremental progress has been made. This is an historic opportunity to finally finish the job and ensure that all children are covered and cared for. It is an economic and moral imperative.

What does all of this mean for the children in your state?

Learn more with our Children's Health Coverage State Fact Sheets.