Document Type

Issue Brief

Publication Date



The State Children's Health Insurance Program (CHIP) — a major program to cover low-income, uninsured children — was passed as part of the Balanced Budget Act of 1997. Its passage was part of a trend of a shifting balance of power between the federal and state governments, particularly in the policy areas of health and social welfare. This issue brief explores the degree of freedom afforded the states by CHIP, the factors guiding state decision making and planning, and the factors influencing the states' various decisions about CHIP. It also discusses state options in four basic areas: participation or nonparticipation in CHIP; expansion of state Medicaid programs versus development or enlargement of separate state programs for uninsured children, using CHIP funding allotments; the levels at which eligibility levels are set; and ways to contain crowd-out.


Issue brief no. 725

Open Access




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