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Children's Health Insurance Program Financing

The Children's Health Insurance Program (CHIP) is funded jointly by the federal government and states through a formula based on the Medicaid Federal Medical Assistance Percentage (FMAP). As an incentive for states to expand their coverage programs for children, Congress created an “enhanced” federal matching rate for CHIP that is generally about 15 percentage points higher than the Medicaid rate — averaging 71% nationally. For example, if a state has a 50% match rate for Medicaid, they may have a 65% match rate for CHIP. 

See information on Medicaid financing.

CHIP Funding Allotments

Because CHIP is a capped program, each state is provided an annual CHIP allotment. Every fiscal year, the Centers for Medicare & Medicaid Services (CMS) determines the share of program funding they will pay that year. States must provide matching funds to get their federal funding allotment. 

Affordable Care Act Enhances Federal CHIP Funding

The Affordable Care Act extends CHIP through most of 2015 and beginning October 1, 2015 the already enhanced CHIP federal matching rate will increase by 23 percentage points, bringing the average federal matching rate for CHIP to 93%.  The enhanced federal matching rate continues until September 30, 2019.  More information on federal funding in the Affordable Care Act.

Medicaid & Children’s Health Insurance Program Budget & Expenditure System (MBES/CBES)

CHIP Expenditure Forms

States can operate CHIP as a program separate from Medicaid, as an expansion of the Medicaid program, or a combination of both program types. 

States submit CHIP forms CMS-64 and CMS-21 to CMS to make sure that federal payments for state expenditures under Medicaid and CHIP are appropriate and to track the number of children served by the programs.

CHIP as Medicaid Expansion

States that operate their CHIP as an expansion of Medicaid use forms CMS-37 and CMS-64.   

Administrative costs associated with CHIP programs operated as an expansion of a state Medicaid program may also be included on the forms CMS-21 if the state opts to claim Federal Financial Participation (FFP) at the enhanced Federal Medical Assistance Percentage.

CHIP as Separate Program

States that operate their CHIP as a separate program use the Quarterly CHIP Statement of Expenditures to submit their actual recorded expenditures and the disposition of federal funds each quarter.

States enter estimated costs for the separate CHIP program on the CMS-21B series of forms, while actual spending cost data is entered on the CMS-21 series of forms.