Children's Health Insurance Expansions: State Experiences in Developing Benefit Packages and Cost-Sharing Arrangements. The Three Caring Programs


Three of these state-sponsored programs were modeled after the Blue Cross Blue Shield Caring Programs: the Pennsylvania Children's Health Insurance Program (CHIP), which was implemented in 1993 and serves children up to age 16 under 185% FPL; the Colorado Children's Health Plan (CCHP), which was implemented in 1992 and serves children up to age 13 under 185% FPL; and the CaliforniaKids program, which was implemented in 1992 and serves children ages 2-18 under 200% FPL. All three programs were initially designed to provide coverage for a population of low-income uninsured children in a specific region of each state. While the CaliforniaKids program has remained somewhat localized, serving 33 counties in California, the programs in Colorado and Pennsylvania have expanded in order to serve children statewide. Among the stand-alone insurance programs examined in this paper, CaliforniaKids is unique in that it is entirely a privately funded initiative. CaliforniaKids is a corporate-sponsored, community-based program that was originally piloted in 1992 as part of Blue Cross of California's Partnerships Program. The Pennsylvania Children's Health Insurance Program is supported by a two cent per pack state cigarette tax, generating approximately $21.5 million annually. In 1996, the program's request for an additional one cent per pack did not pass but the state Legislature appropriated an additional $10 million for the program. Colorado's program receives support from a combination of state appropriations and private donations including the state general fund, a portion of the Medicaid teaching adjustment paid to the University Hospital, state cash reserves and interests paid on those reserves, private donations, and enrollment fees.