SCHIP enrollment could be headed for a dive

A new government report shows that several states will run through their allotments before the end of next year.

By By Joel B. Finkelstein, AMNews correspondent. Aug. 8, 2005.

Washington --While the State Children's Health Insurance Program remains politically very popular, there seems to be little will in Congress to deal with looming funding shortfalls that could lead to new state cuts.

In the past few years, some states reduced physician reimbursement, pared back outreach efforts and created new cost-sharing arrangements. Most recently, some states began freezing enrollments. Last year, that resulted in a drop in the SCHIP rolls for the first time since the program was launched in 1998.

Now with a new report from the Congressional Research Service predicting that more than a dozen states will run out of federal money for the program before the end of 2006, experts say they expect enrollment freezes to continue. That, in turn, would lead to millions of children having a harder time accessing care.

Greg Martin, who analyzes state government issues for the American Academy of Family Physicians, believes that coverage could be threatened for as many as 2.8 million of the 6.2 million children in SCHIP.

"What we're talking about is a program that has become an integral part of states' strategies to ensure kids have access to care," he said.

Physicians shouldn't be surprised to see large, if brief, fluctuations in SCHIP enrollment over the next few years, said Ian Hill, senior research associate at the nonpartisan Urban Institute's Health Policy Center.

Hill and colleagues have monitored changes to the program in several states over the past few years. Freezing SCHIP sign-up is the quickest and easiest way states have to shave money from the program, he said.