SCHIP Guidelines: Principles for Health Insurance Coverage for Children and Families
Policy Fact Sheet
Joseph Antos, John E. Calfee , Robert B. Helms | AEI Online
May 21, 2007
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Members of the Health Policy Consensus Group offer the following guidelines to policymakers for consideration during debate over reauthorization of the State Children’s Health Insurance Program (SCHIP). We also offer a brief summary of our larger vision of expanding access to health insurance.

Component #1: Funding for SCHIP should be redeployed to more effectively expand coverage to children who are most in need and give them access to private health insurance.

In order to accomplish this objective, we believe Congress should be guided by the following principles:

  • The primary focus of the State Children’s Health Insurance Program should be to cover children in families with incomes at or below 200 percent of poverty. These are children whose families make too much to qualify for Medicaid but who often cannot obtain private health coverage.
  • The program’s subsidies should be restructured to encourage the purchase of private health insurance. SCHIP subsidies could be used to allow parents to purchase the health coverage that they believe is best for their children, including adding them to policies that may be offered at their workplaces. SCHIP funds then could be employed to create a bridge to private coverage for children and families.
  • The federal-state matching ratio for SCHIP funding should be changed to eliminate the perverse distortions that exist in today’s system. States receive a higher federal matching rate for covering SCHIP recipients (which today include many adults) than they receive for covering children eligible for Medicaid, even though these children are in families with lower incomes.
  • SCHIP must not be turned into another entitlement program modeled after Medicaid, with unlimited federal funds matching state spending on benefits. That would add to the taxpayers’ already-overwhelming burden of tens of trillions of dollars in unfunded liabilities. It also would encourage states to use accounting tricks to inappropriately increase federal payments. SCHIP must remain as a capped funding program to the states, and Congress must require states to live within their allocations. The states should, however, be given more flexibility in how they spend both SCHIP and Medicaid funds, as we describe below. . . .

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Joseph R. Antos is the Wilson H. Taylor Scholar in Health Care and Retirement Policy at AEI. John E. Calfee is a resident scholar at AEI. Robert B. Helms is a resident scholar at AEI. They, along with the other signatories of this policy fact sheet, are members of the Health Policy Consensus Group.

About the Author

 

Joseph
Antos

  • Mr. Antos's research focuses on the economics of health policy—including Medicare and broader health system reform, health care financing, health insurance regulation, and the uninsured—and federal budget policy. He has written and spoken extensively on the Medicare drug benefit and has led a team of experienced independent actuaries and cost estimators in a study to evaluate various proposals to extend health coverage to the uninsured. His work on the country’s budget crisis includes a detailed plan to achieve fiscal stability and economic growth developed in conjunction with AEI colleagues.  


    Joseph Antos is also a commissioner of the Maryland Health Services Cost Review Commission and a health adviser to the Congressional Budget Office.  Before joining AEI, Mr. Antos was Assistant Director for Health and Human Resources at the Congressional Budget Office.




    Watch Mr. Antos in an interview with Bill Erwin of the Alliance for Health Reform on "Will Health Reform Reduce the Federal Deficit?"

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  • Phone: 202-862-5938
    Email: jantos@aei.org

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    Name: Catherine Griffin
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John E.
Calfee

  • Economist John E. Calfee (1941-2011) studied the pharmaceutical industry and the Food and Drug Administration (FDA), along with the economics of tobacco, tort liability, and patents. He previously worked at the Federal Trade Commission's Bureau of Economics. He had also taught marketing and consumer behavior at the business schools of the University of Maryland at College Park and Boston University. While Mr. Calfee's writings are mostly on pharmaceutical markets and FDA regulation, his academic articles and opinion pieces covered a variety of topics, from patent law and tort liability to advertising and consumer information. His books include Prices, Markets, and the Pharmaceutical Revolution (AEI Press, 2000) and Biotechnology and the Patent System (AEI Press, 2007). Mr. Calfee wrote regularly for AEI's Health Policy Outlook series. He testified before Congress and federal agencies on various topics, including alcohol advertising; biodefense vaccine research; international drug prices; and FDA oversight of drug safety.

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Robert B.
Helms
  • Robert B. Helms has served as a member of the Medicaid Commission as well as assistant secretary for planning and evaluation and deputy assistant secretary for health policy at the U.S. Department of Health and Human Services (HHS). An economist by training, he has written and lectured extensively on health policy and health economics, including the history of Medicare, the tax treatment of health insurance, and compared international health systems. He currently participates in the Health Policy Consensus Group, an informal task force that is developing consumer-driven health reforms. He is the author or editor of several AEI books on health policy, including Medicare in the Twenty-First Century: Seeking Fair and Efficient Reform and Competitive Strategies in the Pharmaceutical Industry.
  • Phone: 2028625877
    Email: rhelms@aei.org

  • Assistant Info

    Name: Catherine Griffin
    Phone: 2028625920
    Email: catherine.griffin@aei.org
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