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February 2007

SCHIP Scheduled for Reauthorization

The State Children’s Health Insurance Program, or SCHIP, is scheduled for reauthorization this year. In its 10-year history, SCHIP has been very successful in reducing the number of uninsured children and has received widespread, bipartisan support. The program currently faces large funding challenges that are expected to dominate reauthorization discussions. Federal action on SCHIP will have a major impact on many states’ existing programs as well as some states’ prospects for coverage expansion.

In FY 2007, 14 states are expected to experience a federal funding shortfall. Six of these states are anticipating shortfalls by early May. Georgia is projecting that its PeachCare for Kids program will run out of federal SCHIP funding by the end of March and has taken action to temporarily freeze enrollment in the program.

The President’s FY 2008 budget proposal recommends the reauthorization of SCHIP and calls for a $5 billion increase in federal funding over the next 5 years. However, Congressional analysts estimate that an additional $12 billion to $15 billion will be needed to eliminate future shortfalls and maintain coverage for existing enrollees.

While SCHIP financing will be a critical topic during reauthorization discussions, other topics will likely surface. For example, Congress may consider redefining and prioritizing SCHIP core populations, providing increased flexibility in SCHIP enrollment, providing wrap-around coverage for under-insured groups, and potentially providing coverage for new groups. Congress will consider the President’s recent budget proposal to limit new SCHIP enrollment to children in families with incomes at or below 200 percent of the federal poverty level. More than half of states could be affected by this provision.

It remains unclear how exactly Congress will proceed with SCHIP reauthorization. SCHIP may be reauthorized with few changes, or Congress may look at larger, long-term financing and policy reforms. In either case, immediate financing solutions will be critical to address projected short-term funding shortfalls.

On February 13, AcademyHealth’s State Health Research and Policy Interest Group held a policy breakfast meeting in conjunction with the National Health Policy Conference that focused on the upcoming reauthorization and potential reform of SCHIP. This interactive session featured a discussion of broad policy considerations, a summary of the implications for reauthorization of nearly a decade of research on SCHIP, and potential challenges for state officials. The agenda and the slide presentations are available at

In addition, more discussion of SCHIP reauthorization is available in The State Children’s Health Insurance Program: Past, Present, and Future, a recent report from The Commonwealth Fund and in Coverage Patterns among SCHIP-Eligible Children and Their Parents, a new paper from the Urban Institute.