February 04, 2015 Practice Points

Should We Be Concerned about the End of CHIP?

By Jessalyn Schwartz

The Children's Health Insurance Program, or CHIP, has made a large impact on the health coverage of children since its inception in 1997. CHIP was reauthorized through the Affordable Care Act (ACA), however, it is only funded through the end of 2015's fiscal year. While the ACA does provide some coverage that may protect children in the wake of CHIP's expiration, they may be left particularly vulnerable.

It is true that most children would qualify for plans offered through healthcare exchanges, but the plans have a twenty-percent lower actuarial value, only covering about 70% of healthcare costs. Additionally, there is an issue with the so-called "family glitch," which occurs when those who are offered sufficient insurance through an employer are not eligible for subsidies, even if the employer coverage does not apply to the employee's family. Often, fewer options exist for pediatric care and plans may not include children's hospitals and networks, limiting the access of children on ACA plans.

Essential benefits, such as dental and vision care, are not part of many plans and the increased cost of these services may make it difficult for children to receive them. The Department of Health and Human Services (HHS) decided that essential benefits would be defined by the states, not a national standard. This makes it possible for children in certain states to be excluded from special needs and disability coverage. The coming year will bring an opportunity to make some necessary decisions about children's healthcare and these considerations are incredibly important for their protection. Read more.

Jessalyn Schwartz is a member of the ABA Children and the Law Advisory Task Force in Boston, Massachusetts.


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