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The SCHIP Debate: UI Findings

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Selected Publications


Can a Child Health Insurance Tax Credit Serve as an Effective Substitute for SCHIP Expansion? (Policy Briefs/Health Policy Online)
Author(s): Linda J. Blumberg, Genevieve M. Kenney

As the State Children's Health Insurance Program (SCHIP) has come up for reauthorization, the coverage of children with incomes above 200 percent of the federal poverty level (FPL) has become a contentious issue. Proposals have surfaced that would subsidizing the purchase of health insurance for children between 200 and 300 percent of the FPL using tax credits and the private insurance market, as an alternative to allowing states to continue enrolling these children in SCHIP coverage. This analysis compares the family financial burdens of covering children under SCHIP and under a refundable tax credit providing a $1400 per child subsidy.

Posted: October 18, 2007Availability: HTML | PDF

Can the President's Health Care Tax Proposal Serve as an Effective Substitute for SCHIP Expansion? (Policy Briefs/Health Policy Briefs)
Author(s): Linda J. Blumberg

The Bush Administration has proposed using a tax deduction approach to expand health insurance coverage instead of expanding SCHIP coverage for more children. On October 3, the president vetoed the SCHIP reauthorization bill passed by Congress. This brief compares the financial burden for families associated with purchasing coverage for their children under the President's proposal and under the SCHIP reauthorization bill and discusses the likely impacts on uninsurance among children. We find that the financial burdens for families between 150 and 300 percent of the federal poverty level would be much higher under the tax deduction approach than under SCHIP.

Posted: October 11, 2007Availability: HTML | PDF

Concerns about Parents Dropping Employer Coverage to Enroll in SCHIP Overlook Issues of Affordability (Policy Briefs/Health Policy Briefs)
Author(s): Stephen Zuckerman, Cynthia Perry

One of the more prominent concerns in the SCHIP reauthorization debate is that many children enrolling in the program could have been insured through their parents' employers. However, concern about parents dropping employer coverage to enroll their children in SCHIP typically ignores the affordability of that coverage. We show that families' spending burden is, on average, lower under public insurance than under employer-sponsored insurance (ESI), especially for the lowest-income families. For families in which children are covered by Medicaid or SCHIP, out-of-pocket spending is, on average, 4 to 5 percent of their income. However, for families in which children have ESI for a full year, the out-of-pocket spending burden is higher, ranging from 12.9 percent of income for families below 150 percent of the federal poverty level (FPL) to 6.1 percent for families between 250-400 percent of FPL.

Posted: October 01, 2007Availability: HTML | PDF

Eligible but Not Enrolled: How SCHIP Reauthorization Can Help (Policy Briefs/Health Policy Briefs)
Author(s): Stan Dorn

More than 6 in 10 uninsured children qualify for Medicaid or the State Children’s Health Insurance Program (SCHIP) but are not enrolled. Reaching these children may not be easy. Medicaid and SCHIP already cover 79 percent of their target population—more than any other traditional, means-tested program. Moving significantly beyond current participation may require non-traditional strategies. For example, Medicare now uses government data to identify eligible, low-income seniors and provide them with subsidies for prescription drugs and other benefits. SCHIP reauthorization could give Medicaid and SCHIP the flexibility to use similar methods for enrolling eligible, low-income children.

Posted: September 24, 2007Availability: HTML | PDF

SCHIP Reauthorization: How Will Low-Income Kids Benefit under House and Senate Bills?
(Policy Briefs/Health Policy Briefs)
Author(s): Genevieve M. Kenney, Allison Cook, Jennifer Pelletier

In July 2007, bills to reauthorize the State Children's Health Insurance Program were passed in both the House and the Senate. One question that has been raised is how well the bills target low-income children. In this brief, Genevieve Kenney and colleagues estimate that the proportion of children below 200 percent of the Federal Poverty Level (FPL) covered by the bills is 70% or higher. The share of uninsured children below 200 percent of the FPL who would gain coverage is estimated to be even higher (78 to 85 percent).

Posted: September 17, 2007Availability: HTML | PDF

What Happened to Health Insurance Coverage of Children and Adults in 2006? (Research Report)
Author(s): John Holahan, Allison Cook

On August 28, 2007, the Census Bureau reported that the number of nonelderly uninsured had increased by 2.1 million in 2006. Of the 2.1 million non-elderly uninsured, 1.4 million were adults and 710,000 were children (age 18 and under). In this paper we show that children experienced declines in employer-sponsored coverage at all income levels. The largest growth in uninsured children (48%) occurred among those in middle-income families (between 200 and 399% of poverty) because there was no increase in Medicaid and SCHIP to offset the decline in employer sponsored coverage.

Posted: September 18, 2007Availability: HTML

Versus: Is SCHIP Expansion a Step Toward Socialized Medicine? (Audio Files)
Author(s): The Urban Institute

Two health policy experts face off on whether it is a reasonable concern that SCHIP expansion is "Congress's attempt to federalize medicine," or instead just empty rhetoric.

Posted: September 19, 2007Availability: HTML

Keep reading: see complete list of SCHIP publications >>