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Children’s Health Insurance Program Is A Critical Lifeline for Low- To Moderate-Income Families and Pregnant Women, And Will Now Be Extended Through 2017 – CHIP Supports Comprehensive Care & Is Critical For Families Whose Income Is Too High to Qualify For Medicaid; A Family of 4 Can Make Up To $100K & Qualify for CHIP


In March, Schumer Pushed Bill To Extend Program; More Than 116,000 Upstate NY Families Would Have Lost Out on $414 Million in Fed Funds if Critical CHIP Legislation Was Not Renewed Quickly


Schumer: Reauthorizing CHIP Means NY will preserve effective, low-cost health plans for nearly 275,000 New York children that were in jeopardy of losing out or facing skyrocketing costs

Today, U.S. Senator Charles E. Schumer announced that critical legislation to extend the Children’s Health Insurance Program (CHIP) through 2017 has cleared Congress. Schumer said this measure was included as part of must-pass legislation this month called the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 and will preserve effective, low-cost health plans for nearly 275,000 New York children that were in jeopardy of losing out or facing skyrocketing costs. Without Congressional action, CHIP was set expire in September and middle-class families who typically pay less than $9 per month for health plans for their children could have been forced to pay anywhere from $50-$400 for coverage. CHIP is critical for helping middle-class and lower-income families afford health care, specifically those whose income is too high to qualify for Medicaid. In March, Schumer pushed for this extension to be included in the “doc fix,” citing that New York State could lose out on up to an estimated $414 million in federal funds in 2016 alone if Congress were to let the funding for CHIP to expire.

“We should never play games when it comes to something as important as keeping our children safe and healthy and insured. There should never be a situation in which children cannot get the checkup or prescription they need because their family cannot afford the payments or insurance,” Senator Schumer. “The inclusion of this provision to extend the CHIP program – which is a real lifeline for thousands of middle-class families seeking health coverage for their children is great news for New Yorkers. Extending this program as long as we can was a no-brainer, and that is why I pushed my colleagues in Congress to pass this extension last month,” said Schumer. “No family should ever have to make the agonizing decision between taking their child to the doctor and footing the cost of exorbitant medical bills they cannot afford. Thanks to this legislation, New York will keep an essential piece of our affordable health care puzzle in place for these families through 2017.”

Schumer explained that the Children’s Health Insurance Program (CHIP) is a federal-state partnership that allows middle class families to access affordable health care coverage for their children. Specifically, the CHIP program provides coverage for families whose income is too high to qualify for Medicaid; a family of four, for example, making under $95,400 per year, but above the poverty level, qualifies for CHIP. CHIP is a federal funding stream, Schumer said, that provides states with the money needed to support their individual state programs. Schumer explained that New York State’s CHIP-funded program, Child Health Plus, is able to deliver a critical low-cost health care option for hundreds of thousands of moderate-income children and pregnant women across the state every year because of these federal funds. CHIP covers more than 8 million children and pregnant women in families that earn income above Medicaid eligibility levels nationwide. Schumer said there are approximately 274,814 total Child Health Plus – New York State’s predominantly federally-funded Children’s Health Insurance Program – enrollees throughout the state, 116,607 of whom—roughly 42 percent—are located throughout Upstate New York.

New Yorkers eligible for this program can sign up for Child Health Plus through New York State and then receive these vital health services through their private insurance provider’s plan. Currently, the federal CHIP program contributes 65 percent of the funding needed to support New York State’s Child Health Plus program, which is approximately $34.5 million per month. New York State’s contribution to the Child Health Plus program is approximately $18.6 million per month, or the remaining 35 percent. Schumer said that, because Child Health Plus receives such a significant portion of its funding—roughly $414 million—from the federal CHIP program, the families of the nearly 275,000 children across New York State and 116,607 across Upstate New York that rely on these CHIP funds could be forced to pay skyrocketing premiums if the federal funding had expired. While the CHIP program is authorized through 2019, no new funding is available after fiscal year 2015. This provision preserves and extends CHIP, funding the program through fiscal year 2017.


Currently, the federal government contributes approximately $34.5 million per month for New York’s Child Health Plus program, or 65 percent of the total government share. New York State’s contribution to Child Health Plus is approximately $18.6 million per month, or 35 percent. Under the current program, CHIP provides comprehensive coverage, including routine check-ups, immunizations, doctor visits, prescriptions, dental and vision care, inpatient and outpatient hospital care, laboratory and X-ray services, and emergency services. While the health premium costs are different in each state, under the CHIP guidelines, no enrollee is required to pay more than 5 percent of their family's income for the year. New York State's Child Health Plus program allows children 6 to 18 years of age who fall between 160-400 percent of the Federal Poverty Level to pay a monthly fee lower than $9 per child.