Happy Anniversary: CHIP at 25

The U.S. Department of Health and Human Services (HHS) Secretary Xavier Becerra and Centers for Medicare & Medicaid Services (CMS) Administrator Chiquita Brooks-LaSure released the following statements to mark the 25th anniversary of the Children’s Health Insurance Program (CHIP) on August 5, 2022:

Secretary Xavier Becerra: “For 25 years, the Children’s Health Insurance Program has provided millions of children and pregnant women with critical health insurance coverage and peace of mind knowing they can get the health care they need. I was proud to be part of the historic effort to create CHIP as a Congressman in 1997, and now I am proud to lead historic efforts to strengthen this program as Secretary of HHS.”

CHIP provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid. In some states, CHIP covers pregnant women. Each state offers CHIP coverage and works closely with its state Medicaid program.

Many people see Medicaid as a single program, when in fact each state has its own plan, and who qualifies for Medicaid varies greatly from state to state. While the numbers would be hard to quantify, it is clear that people may move from one state to another in order to qualify for Medicaid. My home state of Florida has particularly restrictive requirements on Medicaid eligibility.

While CHIP benefits are different in each state, all states provide comprehensive coverage, including:

  • Routine check-ups
  • Immunizations
  • Doctor visits
  • Prescriptions
  • Dental and vision care
  • Inpatient and outpatient hospital care
  • Laboratory and X-ray services
  • Emergency services

With all the positive things about the CHIP program, it has complicated the computation and allocation of federal funding. It is certainly confusing that while CHIP claims are paid by state Medicaid plans, CHIP recipients, by definition, do not qualify for Medicaid and CHIP claims should not be included as Medicaid claims in state and federal filings.


Timothy Powell, CPA

Timothy Powell is a nationally recognized expert on regulatory matters, including the False Claims Act, Zone Program Integrity Contractor (ZPIC) audits, and U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) compliance. He is a member of the RACmonitor editorial board and a national correspondent for Monitor Mondays.

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