Expanding Health Insurance Coverage for Children Under Title XXI of the Social Security Act
CONGRESSIONAL BUDGET OFFICE (U S CONGRESS) WASHINGTON DC
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Since the demise of the Presidents health care reform initiative in 1994, both the President and the Congress have moved away from comprehensive proposals to provide health coverage for the uninsured. Instead, they have sought more incremental approaches that target particular subgroups of the population. The Balanced Budget Act of 1997 expanded health insurance coverage for children by establishing the State Childrens Health Insurance Program S-CHIP as part of title XXI of the Social Security Act. Advocates maintain that uninsured children are a logical group for whom to expand coverage. They are relatively inexpensive to insure and could gain considerable benefits from coverage. Uninsured children are less likely than those with insurance to have a regular health care provider, to see a physician during the year, or to be fully immunized. Moreover, despite the expansions in Medicaid coverage for children that occurred in the early 1990s, the proportion of children who are uninsured appears to be growing. Recent estimates suggest that more than 15 percent of children are uninsured, the large majority of whom come from low-income families. S-CHIP will provide federal matching funds to assist the states in providing coverage for such children. Most states will undoubtedly choose to participate in the program, raising their Medicaid income-eligibility standards for children, establishing separate health insurance programs for them, or, in some cases, doing both. Although those initiatives should reduce the number of uninsured children significantly, some displacement of both private and other publicly financed coverage is likely to occur.
- Administration and Management