More than 8 million children across the country have no health insurance. For that reason, Congress passed a law in August of 1997, which provides health insurance for free or at a very low cost for millions of children nationwide. The program, called Children’s Health Insurance Program (CHIP), offers health coverage to uninsured children whose families earn too much for Medicaid but find it difficult to afford private coverage. The program was reauthorized under the Children’s Health Insurance Program Reauthorization Act (CHIPRA) on February 4, 2009. The program will expand coverage from 7 million children to 11 million children. The new health care insurance reforms signed into law by President Obama on March 23, 2010 will fund CHIPRA through fiscal year 2015. After that date, children and families will be able to get coverage through insurance exchanges. The coverage must be “at least comparable to the benefits offered and cost-sharing protections provided” by CHIPRA.
Under CHIPRA, more children will have health coverage, and states will have more funding and resources to run the program. The new act gives states a number of new options: the option to cover legal immigrant children and pregnant women within five years of immigration; the option to cover pregnant women with CHIP funds; and the option to cover children in families with incomes up to 300% of the federal poverty line. Under the previous guidelines, legal immigrant children were not eligible until five years after they entered the United States. Pregnant women were previously eligible for other waivers and sources of funding other than CHIP funds. CHIPRA also eliminates family-based coverage, which means parents and childless adults are no longer eligible for CHIP funds.
Who Is Eligible?
Each state has different eligibility rules, which also depends upon the number of individuals living in one household. The following guidelines for eligibility are based on 300% of the federal poverty line. The federal government will match the state’s contribution toward health care for children in households with this income level or below: 
Uninsured children 18 years of age and younger whose families earn up to:
$43,710 for a family of two
$54,930 for a family of three
$66,150 for a family of four
$77,370 for a family of five
$88,590 for a family of six
In addition, larger families qualify with even higher incomes.
Can Children in Working Families Qualify?
As you can see, Children’s Health Insurance Program is not a welfare program. Many working families have children who are not covered by employer-sponsored health insurance or other private health insurance and therefore may be eligible if they earn less than the income listed above.
What Services Does Chip Cover?
For little or no cost to a child’s caregiver, CHIP pays for inpatient and outpatient hospital services, doctors’ fees (for surgery and other medical services), laboratory and x-ray services, well-baby and well-child care, age-appropriate immunizations, prescription drugs, mental health services, dental coverage, and vision and hearing services.
How Much Does the Health Insurance Cost?
The insurance is free for some families, and available at a very low cost for others. The costs vary depending on the state and your family’s income, but when there are charges, they are minimal.
Who Pays for It?
Your tax dollars pay for these state and federally sponsored programs.
Who Can Apply for Health Insurance for My Child?
Parents, grandparents, and legal guardians can enroll children in their care for health insurance through CHIP depending on the state in which you live.
What Information Do I Have to Provide in Order to Obtain Health Insurance for My Child?
You will have to provide information about your family’s income and possibly show proof of that income, depending on the state in which you live. In addition, you might have to provide social security numbers for your children or some other documents proving you are in the country legally.
Who Can I Contact to Find Out More Information About My State’s Program and How Do I Apply?
To find out more information or to apply, please call the toll-free hotline at 1-877-KIDS-NOW (1-877-543-7669). The person answering the phone will be a representative of the Children’s Health Insurance Program in your state who can help answer any questions for you. In addition, they can send you an application and help you apply.
All articles are reviewed and approved by Dr. Diana Zuckerman and other senior staff.
- Center for Children and Families Georgetown University Health Policy Institute. (2009). The children’s health insurance program reauthorization act of 2009: Overview and summary. Retrieved from the Center for Children and Families website. http://ccf.georgetown.edu/wp-content/uploads/2012/03/chip-summary-03-09.pdf
- Patient Protection and Affordable Care Act, H.R. 3590 (2010). Accessed April 29, 2010. https://www.congress.gov/bill/111th-congress/house-bill/3590
- Children’s Health Insurance Program Reauthorization Act of 2009. Public Law 111-3. 111th Cong. (2009).