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February 2, 2009

Update on the State Children's Health Insurance Program

Arch Pediatr Adolesc Med. 2009;163(2):103-107. doi:10.1001/archpediatrics.2008.558

Despite apparent widespread support,1-12 the State Children's Health Insurance Program (SCHIP)—a program that provides health insurance for millions of near-poor children—was not reauthorized in 2007.13-15 At a time when many states were considering SCHIP a pivotal piece of larger plans to achieve universal health insurance coverage for children,14 two 5-year SCHIP reauthorization bills, HR 97616 and the final 2007 proposal HR 3963,17 were passed by Congress and sent to the president in 200718 (an earlier bill, HR 3162,19 that was more expansive than either of these passed the House of Representatives but was never voted on by the Senate). Both were vetoed, and neither veto override was successful. At the eleventh hour (December 2007), a short-term extension of SCHIP was approved instead of a 5-year reauthorization. This law, S 2499/Pub L 110-173,20,21 extended SCHIP only through March 2009. It included funds to address short-term SCHIP budget shortfalls but did not include policy changes to address key controversial issues.22 It was therefore a short-term solution and now requires that SCHIP be revisited soon if the program is to be maintained, let alone expanded. The last congressional proposal of 2007 (HR 3963) and the short-term extension law (S 2499/Pub L 110-173) are described in the Table.

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