The State Children’s Health Insurance Program is run by the Department of Health and Human Services in the United States. It is a program meant to provide matching funds for the health insurance held by families who have children. This program was specifically design to cover the children who are uninsured and come from families that earn a modest income (at 200 percent or below the poverty line as designated by the federal government) which is too high to qualify them for Medicaid but is not sufficient for them to purchase other types of health insurance on offer. This paper presents the some of the features of SCHIP which enabled it to successfully achieve it mandate to sole the problem of health care access and how it can be of use in addressing the issue of universal coverage facing the country
State Children’s Health Insurance Program
When the program was incepted in 1997, it presented the largest expansion of the health insurance coverage for minors in the country that fall under the funding of the tax payer. Individual states have flexibility in terms of how they design the requirements and policies for eligibility within the broader federal guidelines (Davenport 2007).
SCHIP was responsible for ensuring that the number of children who are not insured dropped by over 2.7 million cases between 1998 and 2005. This is a drop of approximately 25 percent and is commendable in light of the child poverty numbers increasing and a significant drop in the number of children whose family were covered by job-based health insurance during this period. SCHIP has been noted as a vital program for children as it improves the health care provided to children. hildren who are enrolled in the program are three times likely to receive normal health care than those who are not insured. They also have a one and half more chance to receive well-child care, get dental care as well as see a doctor at least once in the year. SCHIP has been instrumental in reducing the percent of children who have health care needs that are unmet. Vulnerable children- adolescents who have special healthcare needs, minorities’ children as well as those who are long term uninsured are just some of the enrollees on the program.
What are the basic values that underlie this approach to solving the access to care problem? Support your response (Ewing 2008).
SCHIP is funded jointly by the state and the federal governments. The program can be implemented at state level as an extension of the Medicaid program, it can be designed as a stand-alone program or the state can craft a combination of the two. The state has the autonomy to charge premiums, vary benefits and may also require cost-sharing. This is purely an insurance program unlike Medic aid which designed to provide fro retroactive enrollment so as to offset the costs providers incur in the treatment of the uninsured. Most of the states built their programs around care plans that are privately managed and in most cases sidestepped the issues of panel design or provider payment. This organizational structure has allowed for innovations as well as research on the said innovations that have proved that the current institutional structures for health insurance expansion can work. The program design is approved by the federal government which then provides the required chunk of funding. This acts to provide oversight (Ewing 2008).
The financing for the program which provides a fixed allotment in eaach state that is based on the sixe of the population that is eligible as well as the share of the uninsured is a key incentive for the states to maximize enrollment. This acted to eliminate the informational and administrative roadblocks for potential enrollees and encouraged the administrative simplification as well as the experimentation of alternative strategies to market the program. The state explored with public programs that serve target populations that include the school lunch program and food stamps as ways of identifying and recruiting new enrollees. All these factors act to address the issue of universal coverage (Glied 2007).
The state experience derived from the SCHIP program features prominently on debate regarding the universal healthcare reform. This has acted to spur many state legislatures to embark on expanding the coverage of the program further. The program provides evidence to back the feasibility of building on the insurance structures that are already in place as well as illuminates the limits that exist in outreach and marketing in the effort to achieve universal coverage (Glied 2007).
In spite of its diminutive size SCHIP has contributed immensely to both policy and research. The programs benefits 20 percent as many children covered by Medicaid, costing only 3 percent of the Medicaid program. Its design which acts optimally to encourage the states to offer laboratory settings for policy design enables it to impact on the population. This design now acts as a springboard though which health services researchers and policy makers, offering timely and relevant data as well as innovative methods the provides practical lessons that can be applied on a much broader and costlier level of health insurance expansion.