CHIP’s future will be debated in the coming months at the same time that major coverage-related changes under the Affordable Care Act are taking shape. Lessons from the evaluation can inform future decisions about CHIP and point to key areas of uncertainty.
The coming years offer the potential to build upon the coverage and access gains and financial protections for children and their families that came as a result of CHIP, due in large part to the expected gains in health insurance coverage for their parents. The Affordable Care Act coverage expansions are expected to improve the health and wellbeing of parents and other low-income adults, particularly in states that choose to expand Medicaid under the Affordable Care Act. Further reductions in uninsurance among children are also possible given the availability of Marketplace subsidies and health insurance reforms and the new outreach, enrollment, and renewal processes that are being implemented.
This study, like the prior Congressionally-mandated evaluation in ten states, has demonstrated the successful role that CHIP has played in meeting children’s health care needs in very different contexts and with very different program structures, adapted to states’ unique circumstances. The central question for policy makers is how to build upon CHIP’s accomplishments to achieve additional coverage, access, and quality gains for children.