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Evidence, Politics, and the Future of the Children's Health Insurance Program.

The major expansion of health insurance coverage through the creation of the Children’s Health Insurance Program (CHIP) in 1997 was driven by the recognition that millions of children—those whose family incomes were too high to qualify for Medicaid but for whom other insurance was unobtainable—were falling through the cracks of the US health insurance system. At the time, CHIP appeared a bipartisan victory, representing an expansion of public insurance coverage that gave states wide latitude to contract with private plans or place limits on enrollment. 1 By 1999, all states had implemented CHIP. Since the creation of the program, states have implemented a diverse array of policy options under CHIP to serve children and have dramatically improved access to and continuity of insurance coverage for children in low-income families. In the short term, funding for CHIP is likely to be temporarily extended by Congress. In the long term, the future of CHIP should be part of a serious and bipartisan discussion among policy makers about how to best ensure access to health insurance for children in low-income families and develop a comprehensive health policy approach for children and families.