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The Future of California's SCHIP Program: Analyzing the Proposed Federal Legislation

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Publication Date: September 2007

Publisher(s): California HealthCare Foundation

Author(s): Peter Harbage; Jennifer Ryan; Lisa Chan

Topic: Health (Health services for children)

Type: Report

Coverage: California

Abstract:

The federal State Children's Health Insurance Program (SCHIP), created in 1997, has been a basic source of funding for children's health coverage programs in California. With the budget authorization that provides money for SCHIP set to run out, Congress and the President are at odds over legislation to reauthorize the program. These publications contain CHCF's analysis of the policy issues behind the debate and its potential ramifications for California.

*Funding California's SCHIP Coverage: What Will It Cost? During the last decade, California has spent $5.3 billion in SCHIP dollars to provide coverage to more than a million children and women. However, limits on federal SCHIP funding proposed in 2007 could affect future coverage for as many as 1.5 million Californians. This CHCF-funded report provides a financial analysis of how much money the state will require to maintain and expand SCHIP coverage over the next five years.

The report concludes that both SCHIP and the future of publicly funded health coverage for children are at a crossroads. As with Medicare for the elderly, SCHIP and Medicaid have become the backbone of health coverage for the nation's youngest and most vulnerable populations. Failure to reauthorize or fund this program has the potential to eliminate a decade of success insuring this population, including many transitional programs funded by SCHIP that support moving children into the Medicaid program. *The Future of California's SCHIP Program: Analyzing the Proposed Legislation. This report examines the two most prominent proposals Congress considered in crafting its compromise bill. It assesses the issues relevant to the funding debate, including possible policy changes to rules governing eligibility, benefits, and cost sharing. The authors conclude that either measure -- The Children's Health First Act (Rep. Dingell/Sen. Clinton) or The SCHIP Reauthorization Act of 2007 (Senators Rockefeller and Snowe) -- would improve upon the current system by allocating resources and establishing funding levels that will be more responsive to state needs.

Left unresolved is the issue of whether the federal government will make sufficient money available for California to cover all children in the state. Regardless of the outcome, the authors note, the debate over SCHIP reauthorization offers an important opportunity to reassess health coverage priorities and approaches. *The Possible Impact upon California of Reduced SCHIP Funding (September 26, 2007). With President Bush threatening to veto the congressional compromise bill, this white paper examines the potential scenarios for continued SCHIP funding and summarizes how they would affect California's coverage programs. It finds that without full federal reauthorization, the state may be forced to shut down its SCHIP-funded programs by mid-2008, and perhaps begin limiting enrollment as early as this fall. *Assessing California's Ability to Comply with New Federal SCHIP Rules (October 5, 2007). The U.S. Centers for Medicare and Medicaid Services (CMS) recently informed states about new requirements for the State Children's Health Insurance Program (SCHIP). This paper examines the potential impact if California cannot fully comply. The state may be left with three options: mount a challenge to the federal requirements as New York State and other states have done, face the promised corrective action, or stop using SCHIP funds to cover children in families above 250 percent of FPL.