Federally Administered Means-Tested Programs - State Child Health Insurance Program

The Balanced Budget Act of 1997 (PL 105-33) set aside $24 billion over five years to fund the State Children's Health Insurance Program (SCHIP) in an effort to reach children who are uninsured. This was the nation's largest children's health-care investment since the creation of Medicaid in 1965. SCHIP requires states to use the funding to cover uninsured children whose families earn too much for Medicaid but too little to afford private coverage. States may use this money to expand their Medicaid programs, design new child health insurance programs, or create a combination of both.

States must enroll all children who meet Medicaid eligibility rules in the Medicaid program rather than in the new SCHIP plan. They are not allowed to use SCHIP to replace existing health coverage. In addition, states

TABLE 8.13
Number of Medicaid recipients, total vendor payments, and average amounts, by type of eligibility category, fiscal years 1972–98

Fiscal year	Total	Aged 65 or older	Blind	Permanent and total disability	Dependent children under age 21	Adults in families with dependent children	Other
	Number (in thousands)
1972	17,606	3,318	108	1,625	7,841	3,137	1,576
1975	22,007	3,615	109	2,355	9,598	4,529	1,800
1980	21,605	3,440	92	2,819	9,333	4,877	1,499
1985	21,814	3,061	80	2,937	9,757	5,518	1,214
1986	22,515	3,140	82	3,100	10,029	5,647	1,362
1987	23,109	3,224	85	3,296	10,168	5,599	1,418
1988	22,907	3,159	86	3,401	10,037	5,503	1,343
1989	23,511	3,132	95	3,496	10,318	5,717	1,175
1990	25,255	3,202	83	3,635	11,220	6,010	1,105
1991	28,280	3,359	85	3,983	13,415	6,778	658
1992	30,926	3,742	84	4,378	15,104	6,954	664
1993	33,432	3,863	84	4,932	16,285	7,505	763
1994	35,053	4,035	87	5,372	17,194	7,586	779
1995	36,282	4,119	92	5,767	17,164	7,604	1,537
1996	36,118	4,285	95	6,126	16,739	7,127	1,746
1997	34,872	3,955	…	6,129	15,791	6,803	2,195
1998	40,649	3,964	…	6,638	18,964	7,908	3,176
	Amount (in millions)
1972	$6,300	$1,925	$45	$1,354	$1,139	$962	$875
1975	12,242	4,358	93	3,052	2,186	2,062	492
1980	23,311	8,739	124	7,497	3,123	3,231	596
1985	37,508	14,096	249	13,203	4,414	4,746	798
1986	41,005	15,097	277	14,635	5,135	4,880	980
1987	45,050	16,037	309	16,507	5,508	5,592	1,078
1988	48,710	17,135	344	18,250	5,848	5,883	1,198
1989	54,500	18,558	409	20,476	6,892	6,897	1,268
1990	64,859	21,508	434	23,969	9,100	8,590	1,257
1991	77,048	25,453	475	27,798	11,690	10,439	1,193
1992	90,814	29,078	530	33,326	14,491	12,185	1,204
1993	101,709	31,554	589	38,065	16,504	13,605	1,391
1994	108,270	33,618	644	41,654	17,302	13,585	1,467
1995	120,141	36,527	848	48,570	17,976	13,511	2,708
1996	121,685	36,947	869	51,196	17,544	12,275	2,853
1997	124,430	37,721	…	54,130	17,544	12,307	2,727
1998	142,318	40,602	…	60,375	22,806	14,833	3,702
	Average amount
1972	$358	$580	$417	$833	$145	$307	$555
1975	556	1,205	850	1,296	228	455	273
1980	1,079	2,540	1,358	2,659	335	663	398
1985	1,719	4,605	3,104	4,496	452	860	658
1986	1,821	4,808	3,401	4,721	512	864	719
1987	1,949	4,975	3,644	5,008	542	999	761
1988	2,126	5,425	4,005	5,366	583	1,069	891
1989	2,318	5,926	4,317	5,858	668	1,206	1,079
1990	2,568	6,717	5,212	6,595	811	1,429	1,138
1991	2,725	7,577	5,572	6,979	871	1,540	1,813
1992	2,936	7,770	6,298	7,612	959	1,752	1,813
1993	3,042	8,168	7,036	7,717	1,013	1,813	1,824
1994	3,089	8,331	7,412	7,755	1,006	1,791	1,884
1995	3,311	8,868	9,256	8,422	1,047	1,777	1,762
1996	3,369	8,622	9,143	8,357	1,048	1,722	1,635
1997	3,568	9,538	…	8,832	1,111	1,809	3,597
1998	3,501	10,242	…	9,095	1,203	1,876	1,166
Notes: Fiscal year 1977 began in October 1976 and was the first year of the new federal fiscal cycle. Before 1977, the fiscal year began in July. Beginning in fiscal year 1980, recipients' categories do not add to unduplicated total because of the small number of recipients that are in more than one category during the year.
SOURCE: "Table 8.E2. Unduplicated Number of Recipients, Total Vendor Payments, and Average Amounts, by Type of Eligibility Category, Fiscal Years 1972–98," in Social Security Bulletin: Annual Statistical Supplement, 2000, Social Security Administration, Baltimore, MD, 2000

must decide on what kind of cost-sharing, if any, to require of low-income families without keeping them from access to the program. The only federal requirement is that cost-sharing cannot exceed 5 percent of family income. In 2004, 5.8 million children were enrolled in the SCHIP plan.