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Issue Background

Children's Health Insurance Program (CHIP)

CHIP provides health care coverage for 8.9 million children from low- and moderate-income families. CHIP benefits vary by state, however, all states provide comprehensive coverage for dental care for CHIP enrollees.[1]

 

In mid-January, the Congressional Budget Office (CBO) issued a report detailing how a 10-year CHIP funding extension would save the government $6 billion. Specifically, the CBO noted that because Medicaid, subsidized coverage in the marketplaces, and employment-based insurance plans, which would be the alternative to CHIP coverage, are expected to become more expensive, keeping CHIP instead is projected to save the federal government $6 billion over 10 years.

 

On Feb. 9, Congress passed and President Trump signed another short-term budget agreement, which included a provision to lengthen the six-year funding extension for the Children’s Health Insurance Program (CHIP), passed by Congress last month, to 10 years of funding for the critical program.

 


[1] Medicaid Expansion CHIP programs provide the standard Medicaid benefit package, including Early and Periodic Screening, Diagnostic, and Treatment (EPSDT) services, which includes all medically necessary service, including dental services. States that provide CHIP coverage to children through a Medicaid expansion program are required to provide the EPSDT benefit. Dental coverage in separate CHIP programs is required to include coverage for dental services "necessary to prevent disease and promote oral health, restore oral structures to health and function, and treat emergency conditions." States with a separate CHIP program may choose from two options for providing dental coverage: a package of dental benefits that meets the CHIP requirements, or a benchmark dental benefit package. In October 2009, the Centers for Medicare and Medicaid Services (CMS) sent State Health Officials a letter detailing dental coverage under CHIP.

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2016 American Dental Education Association (ADEA), 655 K Street, NW, Suite 800, Washington, DC 20001 (202) 289-7201