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Reports & Evaluations

The Centers for Medicare & Medicaid Services (CMS) administers the Children's Health Insurance Program (CHIP). CHIP was signed into law in 1997 and has helped to reduce the rate of uninsured children to a record low of 7% in 2012. The program is jointly funded by states and the federal government to expand coverage to uninsured children who are not eligible for Medicaid, but can't afford private coverage. CHIP is a state-administered program and each state sets their own guidelines regarding eligibility and services, according to federal guidelines. The Children’s Health Insurance Program Reauthorization Act (CHIPRA) reauthorized CHIP in April 2009 and, in 2010, the Affordable Care Act contained provisions to strengthen the program. The Affordable Care Act extended CHIP funding until September 30, 2015, and requires states to maintain eligibility standards through 2019. Legislative action will be required to extend federal funding past September 2015 are available for download.

Comparison of Benefits and Cost Sharing

CMS released a white paper that fulfills HHS’s responsibility under section 2105(d)(3)(C) of the Social Security Act (the Act) to review and compare the benefits and cost sharing in the CHIP and qualified health plans (QHPs) in order to certify QHPs as being comparable to CHIP for pediatric benefits and cost sharing protections.

Annual Enrollment Reports

Each year, CMS collects data from states on the children enrolled in CHIP. These data are reported by states into the Statistical Enrollment Data System (SEDS), and one data element, the unduplicated number of children ever enrolled in Medicaid and CHIP in the federal fiscal year (FY), is published annually on Medicaid.gov. For the purposes of SEDS reporting, “ever enrolled” is defined as the enrollment totals for the program in which children were last enrolled in the FY, either separate CHIP, Title XXI-funded Medicaid, or Medicaid. For example, children who began the year in a separate CHIP but transitioned to Medicaid would be reported in the Medicaid enrollment totals. The published CHIP enrollment totals include children enrolled in separate CHIP and Title XXI-funded Medicaid programs.

Report to Congress

Policy analysis and research reports are submitted to Congress to provide a better understanding of the Medicaid and CHIP programs, their roles in the U.S. health care system, key policy and data issues, and to promote continuous process improvement and transparency within the programs.

Quarterly Expenditure Reports

The Quarterly Children's Health Insurance Program (CHIP) Statement of Expenditures for Title XXI (Form CMS-21) is the state's accounting statement of actual recorded expenditures and the disposition of Federal funds which the states, in accordance with Sections 2105(e) and 2107(b)(1) of the Act, must submit each quarter under Title XXI of the Act. Expenditures reported on this form primarily include those made to initiate and expand health insurance coverage to uninsured, low-income children through a separate CHIP.

Medicaid and CHIP Application, Eligibility Determination, and Enrollment Data

CMS publicly releases data collected through the Medicaid and CHIP Performance Indicator Project through a series of monthly reports.

National Medicaid & CHIP Program Information

As part of ongoing effort to highlight improvements to the Medicaid and CHIP programs brought about by the Affordable Care Act, CMS has developed two Medicaid Moving Forward Reports that provide a comprehensive overview of Medicaid activities undertaken as part of the partnership between the states and the federal government over the past two years.