Today marks the fifth anniversary of the Children’s Health Insurance Program Reauthorization Act (CHIPRA), which extended the authorization for CHIP. In honor of this anniversary, we want to reflect on all the great gains in children’s health coverage we’ve made through CHIP and think about the future of this valuable program.

Since 1997, CHIP has provided federal funding for states to establish public health insurance programs for children in low-income families. States have flexibility to design their CHIP programs as they wish, so these programs are unique to the states they serve. Some states, such as Massachusetts, make CHIP an extension of their Medicaid programs, with the same benefit package offered to children at income levels above the Medicaid cut-off. Other states, such as Connecticut, designed separate programs with different benefits and cost-sharing requirements. Some states created hybrids of these two models–in general, these include Medicaid expansion for the youngest children and a separate program with different benefits for older kids. Add to this complexity the fact that CHIP programs often have surprising names (such as Dr. Dynasaur), and many people may be unaware of the important part CHIP plays in covering kids in their state.  

No matter how a state’s program looks, CHIP is an important resource for families and has been crucial to driving down children’s rates of uninsurance. CHIP coverage itself is instrumental in this aim, but CHIPRA also created the Connecting Kids to Coverage program, which provides grants and support for organizations engaged in outreach and enrollment work. Moreover, CHIPRA performance bonuses incentivize states to enroll as many eligible children as possible and reward these efforts with additional funding.

Finally, CHIPRA created several programs focused on improving the quality of care kids receive. Pediatric quality research has lagged quality improvement efforts for adults, and CHIPRA begins to resolve this disparity through the creation of Centers of Excellence and demonstration grants. Through the demonstration grants, 18 states are engaged in testing out pediatric quality measures, incorporating health information technology and electronic health records into pediatric care, and developing more patient-centered and coordinated methods of providing care. These projects have already had valuable impacts on the quality of care kids receive, and we look forward to the continuation of this work and its broader adoption.

Almost 8 million children get their health coverage through CHIP. In part thanks to the outreach possible through CHIPRA, the uninsurance rate among children is only 7.2 percent nationwide—the lowest it has been since we started collecting data. However, this vitally important program requires Congressional action to continue beyond 2015. It’s up to all of us to educate our legislators about the importance of this program and to ensure that we are able to continue our drive toward insuring all children and providing them with high-quality care.