Celebrating Five Years – Achievements of the Children’s Health Insurance Program Reauthorization Act of 2009 (CHIPRA)

Posted February 4, 2014
By Kathleen Sebelius, Secretary of Health and Human Services

Building off the strong base of coverage for children in Medicaid, the creation of the Children’s Health Insurance Program (CHIP) in 1997 made a significant investment toward advancing health coverage for children.  In the first ten years of CHIP, children gained coverage through both CHIP and Medicaid and changes helped simplify the application process in both programs.  And yet, in 2007, as CHIP was slated for reauthorization, a quarter of the nation’s children did not have an affordable source of health insurance coverage. Reauthorization renewed and refocused the effort on not just expanding coverage for children, but making sure that all of America’s children who are eligible for Medicaid and CHIP are enrolled.  As we reach the 5-year anniversary of this significant legislation, we take stock of what the Children’s Health Insurance Reauthorization Act of 2009 (CHIPRA) envisioned – and celebrate all that has been accomplished.

Happy 5th Anniversary to the CHIP Reauthorization Act: 4 million more children covered since 2008CHIPRA was a top priority for President Barack Obama. It was the second bill he signed into law, just 15 days after his inauguration, on February 4, 2009.  In addition to fully funding and continuing the authority for states to operate their CHIP programs, CHIPRA added new options for states to expand Medicaid and CHIP coverage. This included the option for states to provide coverage to all children who are lawfully present in the United States and otherwise eligible – an option that more than half of the states have elected.  The new law also included a significant investment in outreach, improvements to the Medicaid eligibility and enrollment process and financial incentives for states to adopt innovative, simplified approaches like 12-months continuous eligibility and a new streamlined process known as Express Lane Eligibility.

The legislation reflected strong, bipartisan support for children’s health coverage. To express the Department of Health and Human Services’ commitment to this effort, on the first anniversary of CHIPRA, I issued the Connecting Kids to Coverage challenge. The challenge was a call to state and local government leaders, schools, businesses, coaches, community health centers and other providers and faith-based groups to work with the federal government to enroll all eligible children.  At the time, an estimated 5 million uninsured children were eligible for coverage through Medicaid or CHIP but not enrolled.

The law, the commitment across the country and the Challenge worked, and the results have been positive.  There are 4 million more children insured in Medicaid or CHIP since CHIP was reauthorized; this corresponds to a decline of 3 percentage points in the share of children without health insurance.  Since 1997, the Census Bureau demonstrates that the share of children with family incomes below 200 percent of the federal poverty level who are uninsured was cut nearly by half, from 25 percent in 1997 to 13 percent in 2012, according to data released today by the Assistant Secretary for Planning and Evaluation, commemorating the 5th anniversary of CHIPRA.

Every parent who has breathed a sigh of relief when his or her child enrolled in Medicaid or CHIP now knows that having health coverage offers not just financial security but also better access to care, particularly primary and preventive care.  The research bears this out: four-fifths of children enrolled in Medicaid or CHIP received a preventive visit and 86 percent had a doctor or other health professional visit in 2012. 

There is much to celebrate on behalf of our nation’s children and of course there is still more work to be done.  I urge you to join the Connecting Kids to Coverage challenge if you haven’t already done so.  And  thanks to new coverage that is available through  the Affordable Care Act, there are even more opportunities to help everyone who is eligible for some form of health coverage – whether it be through the Health Insurance Marketplace, Medicaid or CHIP – to enroll and get the care they need.

Happy Anniversary to CHIPRA, and I look forward to the important work of making the next five years in children’s coverage as successful as the last.