CHIPRA Performance Bonus And Its Effect On Children

                As part of a reform on America’s health insurance policies, the Children’s Health Insurance Program was established to make health care more readily available to children in low-income families. In 2007, the Bush administration barred its progress as President George W. Bush vetoed its bill, claiming it would federalize health care and put more pressure on states. In 2009, President Barack Obama jump started the program by issuing the Children’s Health Insurance Program Reauthorization Act or CHIPRA. With the help of the Affordable Care Act, CHIPRA is allowed to assist children in need all across the nation. But the question lies, where would these children be without CHIPRA’s services? To answer that, we look no further than on its effectiveness in recent years.

The Components of the Children’s Health Insurance Program Reauthorization Act

As explained earlier, CHIP seeks to ultimately provide children with quality health insurance by making it easily accessible for them, despite their low-income backgrounds. When the Obama administration reinstated the program, new changes were made. The act provided states with increased funding, improved options, covering children under Medicaid as well as CHIP, and, most importantly, incentives for states to use CHIP. It remained clear how vital it was for the federal government to support states in this time of transition. This included developing practical strategies to identify, enroll, and retain health care coverage for uninsured children, mainly those who are eligible, but not enrolled.

CHIPRA seeks to not only assist states in this process but also increase the rate of children being insured in reliable health care plans by doing the following:

  • Providing the new Express Lane Eligibility option will allow states to enroll children into health insurance services such as Medicaid and CHIP based upon information from other programs and data bases
  • Increasing the funding to states meant for reaching out to communities in order to promote enrollments
  • Providing the new Performance Bonus  will eliminate some of the costs that states will have to pay, giving an incentive to cover children in health care plans through Medicaid or CHIP
  • Providing the option for states to verify U.S. citizenship by the use of data matches with the Social Security Administration in order to reduce health insurance coverage losses and delays, which would eliminate technical setbacks such as lengthy paperwork requirements
  • Automatically having  newborns whose mothers are covered through Medicaid and CHIP be eligible 

The Effectiveness of CHIPRA

The effectiveness of CHIPRA in terms of the number of children insured has increased dramatically over the years. This can easily be seen through simple comparisons. According to the U.S. Census Bureau, in 2008 alone, 7.3 million children were uninsured despite having the lowest uninsured rate of children that year. This was largely due to gaps in coverage and the fact that most were eligible, but were unable to be enrolled. These problems can be caused by administrative barriers as well as families simply not knowing if their children were eligible (

By 2011, enrollment numbers for children reached an added 1.1 million, a significant increase.  And by 2013, various improvements have been made. 47 states in the US provide coverage for children with family income at 200% of the Federal Poverty Level, also known as the FPL, or higher while 26 of them cover children with family income at 250% of the FPL or higher. In 17 states, children were covered with a family income at 300% of the FPL or higher. Often times, this increase in health care coverage can result in unwanted changes such as long waiting lines for medical appointments. In 2013, 13 states do not have a waiting period for CHIP programs and those that do have waiting periods, 19 of them have periods of 3 months or less (

The Future of CHIPRA

The future of this program looks bright as the federal government is continuing its large scale funding. Outreach and enrollment grants from the Connecting Kids to Coverage program are being offered this year. The total comes to about $32 million and is available to states, local governments and community organizations.  With this much funding, the number of insured children is predicted to increase even further (


Scroll to Top