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Covering Uninsured Children and Their Parents: Estimated Costs and Number of Newly Insured

A new Commonwealth Fund-supported report estimates that the new Child Health Insurance Program (CHIP), combined with Medicaid, could reduce the number of uninsured children by 80 percent if states were to enroll all those who are eligible. Covering Uninsured Children and Their Parents: Estimated Costs and Number of Newly Insured, by Kenneth Thorpe and Curtis Florence, finds that more than 9 million of the 11.3 million children under age 19 who do not have health insurance are eligible for coverage under one of the two programs.

Thorpe and Florence, both of Tulane University, point out that 5 million poor or near-poor uninsured children are already eligible for coverage under Medicaid but are not enrolled. An additional 4 million will be eligible under CHIP, which was enacted last year to provide health insurance to children in families with incomes below 200 percent of federal poverty. As state policymakers design programs to take advantage of $24 billion in new CHIP and Medicaid funds, they will need to focus on the next crucial phase–identifying and signing up eligible children.

The authors also note that a large majority (80%) of parents of uninsured children are themselves uninsured. An estimated 6.6 million uninsured adults are parents of children who will be eligible under new CHIP rules or are already eligible for Medicaid (5.1 million), or are parents of children already enrolled in Medicaid (1.5 million). Most of these parents are working, but are not covered through their jobs.

Some states, such as Wisconsin, are considering implementing CHIP programs that would cover parents of eligible children, though federal legislative action to provide matching federal funds would likely be required. Covering uninsured parents under CHIP could improve outreach efforts to children, coordination of family health care services, and family health.

Under CHIP, states have wide latitude in designing and implementing programs. So far, 25 states have had CHIP programs approved, and many are testing options to reach more people, including presumptive eligibility and 12-month coverage without requiring reapplication.

In the final analysis, the success of CHIP will depend on the ability and determination of states to use new tools and resources effectively.

Facts and Figures

  • The new legislation provides $20 billion for CHIP and additional new funding for Medicaid expansions over the next five years, and nearly $50 billion over 10 years.
  • If 75 percent of uninsured parents of CHIP-eligible children participated in the program, 1.7 million parents could be insured at an estimated cost of $4 billion to federal and state governments.
  • If 75 percent of uninsured parents of Medicaid-eligible children were allowed to enroll in the program, 2.5 to 3.4 million parents could be covered for a cost of $6 to $8 billion.

The full report is not available at this time.

Publication Details



Covering Uninsured Children and Their Parents: Estimated Costs and Number of Newly Insured, Kenneth E. Thorpe and Curtis S. Florence, Tulane University, The Commonwealth Fund, May 1998