SCHIP Expansion Includes Mental Health Parity

On February 4 President Obama signed legislation that reauthorizes the State Children's Health Insurance Program (SCHIP) for the next four and a half years and increases spending by $32.8 billion. Provisions in the new law will expand coverage from seven million to 11 million children. The expansion will be funded by an increase in the federal excise tax on cigarettes, from 62 cents per pack to $1.01.

The new law also requires states to cover treatment of mental disorders, including substance use disorders, at the same rate and on the same terms as general medical conditions. It eliminates the discriminatory provision in the previous SCHIP regulations that allowed states that choose to develop benchmark-equivalent plans to lower the amount of mental health coverage to 75% of the amount prescribed in benchmark plans.

Created in 1997, SCHIP is a joint federal and state program that in 2008 provided coverage to 7.4 million uninsured children. SCHIP targets children who live in families with incomes that are about 200% of the federal poverty level, or $42,000 for a family of four in 2008. This level of income is too high in most states to qualify for Medicaid (133% of the poverty level for children under six and 100% for children six to 18) but, for most families, is too low to afford private coverage. Under the new law, states can enroll children in families with incomes up to three times the poverty level, which will help expand coverage to 11 million children by 2013. In addition, the legislation includes parity for dental coverage; eliminates a five-year waiting period for legal, documented immigrant children; and creates a new option for states to enroll low-income pregnant women in SCHIP.

The Kaiser Commission on Medicaid and the Uninsured has created a resource page on the care and coverage of children, with information about the newly reauthorized SCHIP program and an archived Webcast of a panel discussion held one week after the law was signed—"Ask the Experts: The Children's Health Insurance Program Reauthorized: What's Next?" These resources are available at www.kff.org/about/kcmu.cfm .