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Background on SCHIP & S1337

May 22, 2007

The State Children's Health Insurance Program (SCHIP) is a joint federal and state program that provides health insurance coverage to approximately 4 million low-income children.  However, the coverage provided by many states through SCHIP includes discriminatory limits on mental illness treatment, including unjustified caps on inpatient
days and outpatient visits.

Children and adolescents in low-income families, particularly those enrolled in Medicaid and SCHIP, tend to experience higher rates of mental health disorders such as depression and anxiety.
 
Unfortunately, we know that most children with mental health disorders do not receive treatment.  Without early and effective identification and interventions, childhood mental disorders can lead to school failure, poor employment opportunities, contact with the juvenile justice system and a higher risk for suicide.  The limits on mental health care in many SCHIP plans do not allow adequate access to care for children with mental disorders.

S 1337 would prohibit SCHIP plans (i.e. SCHIP plans in states that elect to direct federal SCHIP funds for private sector health plans, as opposed to Medicaid expansion), from applying more restrictive financial requirements or treatment limits for mental illness that do not also apply to other medical services.
  The bill also removes a current restriction in the SCHIP program that allows private sector SCHIP plans to limit mental health coverage to a standard of 75% of the actuarial equivalence of all other health benefits.

 


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