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  • The Center for Rural Homelessness

What is the Child’s Health Insurance Program?

By: Katie Baughman, Policy Intern


The Child’s Health Insurance Program is a program created in 1997 under the US Department of Health and Human Services (DHHS). It aims to provide low-cost health insurance for families who don’t qualify for Medicaid, but who cannot afford private insurance. CHIP is closely affiliated with the Medicaid program, and is similarly administered by individual states under generalized federal guidelines. Each state has its own eligibility requirements, ranging from under 170% of Federal Poverty Level (FPL) to under 400% of the FPL. While CHIP is administered by states, it’s funded jointly, with the DHHS providing matching funds to states. In 2021, CHIP directed $21billion total towards children’s health coverage. 

CHIP has greatly expanded health coverage for children in America, and over 7 million children are currently enrolled in CHIP. Though exact coverage is often left up to the states, CHIP in all cases covers check-ups, lab work, inpatient and outpatient hospital care, etc. CHIP also covers dental, which is excluded from private coverage. CHIP further covers physical, occupational, and speech therapies, which are a resource especially for children with individualized learning needs and disabilities. In some states, healthcare resources are available not only for children but also for low-income pregnant women, who are eligible for prenatal, delivery, and postpartum care. CHIP provides cost-effective healthcare to enrolled families; families save an average of $1222 per child recently enrolled in CHIP.


Rural communities have disproportionately high rates of uninsured individuals and families compared to urban and suburban communities, making CHIP an essential tool in combating uninsurance in rural areas. Though it’s a nationwide program, CHIP also relatively covers more children in rural areas than on average nationwide; children in rural communities are almost 25% as likely to rely on CHIP or Medicaid than children in urban communities. This is not only because of the disproportionate poverty rates in rural America, but also the high rates of seasonal employment and the following lack of employment-provided health coverage for families and children. Then, CHIP is essential in ensuring low-income children have access to affordable healthcare.

Though CHIP, along with Medicaid, works to make sure children are insured, many rural families and children still lack access to healthcare facilities; lengthy travel requirements and lack of adequate resources at rural clinics mean much of the healthcare that rural children receive is provided by their schools. However, schools in rural areas are less likely to bill CHIP or Medicaid than urban areas because of administrative costs and burdens, leaving many rural low-income children still with limited access to healthcare.

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