Health Coverage Expanded for Millions of Children

    • February 4, 2009

The President and the Congress have made health reform a top priority for the 111th Congress, and the reauthorization of the State Children’s Health Insurance Program (Title XXI of the Social Security Act) marks their first step toward that goal. On Feb. 4, after the House and Senate overwhelmingly approved identical versions of H.R. 2, President Obama signed the bill into law. It has welcome implications for a host of children’s health issues, including obesity.

SCHIP was first enacted in 1997 to provide health insurance to children whose parents did not qualify for Medicaid but could not afford private coverage. It originally was funded at almost $40 billion over 10 years. States could use the funds to expand their existing Medicaid programs, create a separate children's coverage program or combine those two approaches. By 2008, about 7 million children were enrolled.

With this reauthorization, an additional $32.8 billion will be provided through September 2013 to preserve health coverage for 6.7 million children and extend coverage to 4.1 million more. SCHIP’s expansion is being financed with a 62-cent cigarette tax increase—a move that is expected to keep nearly 2 million young people from starting to smoke.

Risa Lavizzo-Mourey, president and CEO of the Robert Wood Johnson Foundation, applauded the bill’s enactment. “This legislation is an important first step towards comprehensive health reform that will result in helping all Americans live healthier lives and get the care they need,” she said.

Key Provisions in H.R. 2*

  • A $25 million grant program to develop a comprehensive and systematic model for reducing childhood obesity
  • An improved state allotment formula to reflect actual projected spending in SCHIP
  • Funding for outreach and enrollment efforts
  • Bonus payments to states that increase enrollment of lowest-income children in Medicaid
  • Shared information from nutrition assistance programs and other initiatives for low-income families to help states identify and enroll eligible children.
  • An option to cover pregnant women for prenatal care
  • An option to provide pediatric dental care
  • Removal of childless adults from SCHIP and a prohibition on additional adult coverage
  • No waiting period for legal immigrants’ coverage eligibility

Provisions Related to Childhood Obesity

The new childhood obesity grant program will be administered by the Centers for Medicare and Medicaid Services (CMS). Activities that will be eligible for funding support include: establishing after-school and weekend community activities to reduce childhood obesity; forming partnerships with day-care facilities to establish programs that promote healthy eating and physical activity; planning and implementing a school curriculum on healthy lifestyles; training health professionals on how to identify and treat obese and overweight individuals; and educating families on how nutrition, eating habits and physical activity relate to obesity.

The grant program is specified in Title IV, Sec. 401, Child Health Quality Improvement Activities for Children Enrolled in Medicaid or SCHIP.