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At Issue

The Children’s Health Insurance Program (CHIP), formerly known as the State Children’s Health Insurance Program or SCHIP, was enacted at the federal level in 1997. It is intended to provide health insurance benefits for children with family incomes too high to qualify for Medicaid but too low to afford private health insurance coverage. CHIP is voluntary for states and is financed jointly by the states and the federal government.

In creating their programs, states may combine CHIP with Medicaid, create a separate program or do both. Within broad federal guidelines, each state determines the design of its program, eligibility groups, benefit packages, payment levels for coverage and administrative and operating procedures. States receive an enhanced payment from the federal government for every dollar spent on an approved SCHIP service. However, unlike Medicaid the funding is not open-ended; it is capped at a set amount. While there is no requirement that states offer a dental benefit under CHIP, all states provide at least some level of dental coverage.

Reimbursements for CHIP dental procedures often fail to cover the overhead costs of providing care, making it difficult for enrollees to find a dentist who can afford to take on CHIP patients. To address this problem, providers must be adequately reimbursed for the cost of their services. Addressing administrative hassles and patient adherence with treatment regimens would also improve the program.

CHIP provides children with much needed access to health insurance and dental benefits and the ADA urged its reauthorization.

Additional Resources

Contact Us

Federal Affairs
1111 14th Street NW, Suite 1100
Washington, DC 20005
Fax: 202.898.2437
Email: govtpol@ada.org
  State Government Affairs
ADA Chicago Headquarters
211 East Chicago Avenue
Chicago, IL 60611
Fax: 312.440.3539
Email: govtpol@ada.org