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The Children's Health Insurance Program (CHIP) was added to the Social Security Act by the Balanced Budget Act of 1997. The purpose of the program is to provide health insurance to the country's uninsured children who are under the age of 19. Alabama was the first state in the nation to have a federally approved CHIP plan. Alabama's CHIP program is the result of a partnership between the Alabama Department of Public Health (ADPH), the Alabama Medicaid Agency and the Alabama Child Caring Foundation.

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Background and Legislative Reports

CHIP was added to the Social Security Act by the Balanced Budget Act of 1997. The Act includes over $50 billion over a ten year period to provide health insurance to America's ten million uninsured children. The Health Care Financing Authority (HCFA), the government agency that also administered the Medicare and Medicaid programs, was designated as the responsible federal agency for CHIP. The State of Alabama was eligible to receive up to $85.6 million per year in federal funds, which combined with the state match of $23.4 million, made up to $109 million available annually.

The Alabama Legislature allocated $5 million to begin CHIP in Alabama. This enabled Alabama to request over $18 million in federal funds to begin implementing CHIP in Alabama during 1998. The Legislature also created a CHIP Commission to oversee the development of the state's plan for implementing CHIP, and designated ADPH to submit the CHIP plan to HCFA and to receive the federal funds.

Prior to the Alabama legislation being passed, a work group was formed that had already begun developing a CHIP plan for Alabama. The work group included representatives from numerous agencies, professional associations and interest groups. With ADPH and the Alabama Medicaid Agency taking a coordinating role, the work group determined a two phased approach would be the most beneficial for Alabama's children. The work group was organized into three subcommittees: Eligibility, Benefits and Financing. Two other subcommittees have since been formed: Outreach as a part of Eligibility and Information and Data Systems.

Phase I

In order to begin covering more children as quickly as possible, Alabama applied to HCFA (now Centers for Medicare and Medicaid) for a Medicaid Expansion to cover children born before October 1, 1983 who were up to age 19 and under 100 percent of the Federal Poverty Level (FPL). Alabama received a favorable response from HCFA regarding the Phase I application that indicated the Alabama plan might be approved shortly. The target date for implementation was set for February 1, 1998.

Phase II and the CHIP Commission

The legislatively designated CHIP Commission met for the first time on October 7, 1997. Major actions were to authorize the multi-phased approach to implement CHIP in Alabama, to endorse a full funding (i.e., $23.4 million) budget for 1998, and to authorize continuance of the work group to provide input to the Commission.

The second meeting was held on November 12, 1997. At that time, the Commission heard reports and considered recommendations from the subcommittees. The following actions were taken: to select the HMO package of benefits as the benchmark package for Alabama, to contract benchmark plan administration and to adopt a set of eligibility standards.

The third meeting was held on December 17, 1997. The Commission endorsed expansion of children's health insurance coverage from 100 percent of FPL to 200 percent of FPL through private insurance. The Commission also recommended that bids for the insurance be solicited on both a statewide and a regional basis. In further action, the Commission agreed to serve beyond the time frame defined in the legislation in order to continue oversight of plan development.

The Alabama Legislature allocated $5 million to begin CHIP. This enabled Alabama to request over $18 million in federal funds to begin implementing CHIP during 1998. The Legislature also created a CHIP Commission to oversee the development of the state's plan for implementing CHIP, and designated ADPH to submit the CHIP plan to HCFA and to receive the federal funds.

Commission Members

  • Ed Richardson, Ed.D., State Superintendent of Education
    Represented by Joseph B. Morton, Ph.D., Deputy State Superintendent of Education
  • Commissioner Gwendolyn Williams, Alabama Medicaid Agency
  • Ms. Kitty Terry, Executive Director, Children's Trust Fund of Alabama
  • J. Robert Beshear. M.D., Children First Foundation
  • Marsha Raulerson, M.D., Designee of the Lieutenant Governor
  • The Honorable Gregory Wren, Designee of the Speaker, Alabama House of Representatives
  • The Honorable Dewayne Freeman, President Pro Tem of the Alabama Senate
  • The Honorable Seth Hammett, Speaker Pro Tem, Alabama House of Representatives
  • The Honorable Hank Sanders, Chair, Alabama Senate Finance and Taxation Education Committee
  • The Honorable William J. Fuller, Jr., Chair, Alabama House Ways and Means Committee





Page last updated: February 15, 2024