Children's Health Insurance: State Experiences in Implementing SCHIP and Considerations for Reauthorization

GAO-07-447T Published: Feb 01, 2007. Publicly Released: Feb 01, 2007.
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In August 1997, Congress created the State Children's Health Insurance Program (SCHIP) with the goal of significantly reducing the number of low-income uninsured children, especially those who lived in families with incomes exceeding Medicaid eligibility requirements. Unlike Medicaid, SCHIP is not an entitlement to services for beneficiaries but a capped allotment to states. Congress provided a fixed amount--$40 billion from 1998 through 2007--to states with approved SCHIP plans. Funds are allocated to states annually. States have 3 years to use each year's allocation, after which unspent funds may be redistributed to states that have already spent all of that year's allocation. GAO's testimony addresses trends in SCHIP enrollment and the current composition of SCHIP programs across the states, states' spending experiences under SCHIP, and considerations GAO has identified for SCHIP reauthorization. GAO's testimony is based on its prior work; analysis of the Current Population Survey, a monthly survey conducted by the U.S. Census Bureau (2003-2005); information from states' annual SCHIP reports (2002-2005); and SCHIP enrollment and expenditure data from the Centers for Medicare & Medicaid Services (1998-2005).

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