State policymakers are using the flexibility built into Title XXI to manage their SCHIP programs, cutting or expanding as fiscal conditions permit. This conclusion is based on our third annual survey of SCHIP directors in the 13 ANF states, which explored the impacts of budget pressures on child health insurance policies in 2004. On the plus side, several states reversed previous cuts; for example, every ANF state that capped enrollment in 2003 lifted the cap in 2004. However, states kept many of their prior years' cuts in place during '04, and some imposed new restrictions.
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