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To the Editor: Congress created the State Children's Health Insurance Program (SCHIP) in 1997 to provide public health insurance for families who could not afford private coverage yet earned too much to qualify for Medicaid.¹ Although general guidelines for SCHIP eligibility were 100% to 200% of the federal poverty level (FPL), SCHIP gave states flexibility to set income eligibility. Some states exceed 250% FPL while others have proposed limits up to 400%. The SCHIP reauthorization debate in 2007 raised questions about whether to set income limits at, below, or above existing thresholds and particularly whether SCHIP should expand to 400% FPL.²

Although SCHIP income limits encompassed most uninsured children at its inception in 1997, insurance problems and related sequelae have recently shifted up the income scale.³ Therefore, we examined forgone care among insured vs uninsured children, stratifying by income to approximate the potential eligibility thresholds under debate for SCHIP.

Methods

We . . . [Full Text of this Article]

Laura P. Shone, DrPH, MSW
laura_shone@urmc.rochester.edu

Jonathan D. Klein, MD, MPH; Aaron K. Blumkin, MS; Peter G. Szilagyi, MD, MPH
Department of Pediatrics
University of Rochester School of Medicine and Dentistry
Rochester, New York

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