July 2004

SCHIP Program Enrollment: December 2003 Update

For the past six years, the State Children's Health Insurance Program (SCHIP) has provided states with an effective vehicle to expand health insurance coverage for low-income children. SCHIP, together with the larger Medicaid program, has made substantial gains in reducing the nation's number of uninsured children. However, 2003 marked a turning point for enrollment in SCHIP. Despite the program's striking success in covering low-income children, ongoing fiscal difficulties led some states to make program changes that led to reductions in SCHIP enrollment. As of December 2003, SCHIP provided coverage to 3,927,000 children, a decline of roughly 37,000 from June 2003 when enrollment peaked at 3,964,000. This decline marks the first time in the program's history that enrollment has fallen. Despite this overall decline, 37 states continued to experience modest increase sin enrollment during the last six months of 2003. However, these increases were offset by declines of nearly 145,000 in 11 states and DC, with Texas accounting for more than half (52%) of the total decrease over this six month period. Texas implemented numerous program changes to SCHIP to address the state's budget deficit.