9.1  Preamble

Governors share the commitment of Congress and the Administration to making quality health insurance available to children in need. States have long been leaders in improving health care access for children. Under the Children's Health Insurance Program (CHIP), states are using state-designed programs, Medicaid expansions, or a combination of both approaches to provide access to health insurance for eligible children. The program currently provides health insurance coverage to more than six million children nationwide and the Children’s Health Insurance Program Reauthorization Act of 2009 is designed to reach additional eligible but unenrolled children. Governors support flexibilities in the new law that build upon states’ experiences. The new provisions also modernize the funding formula to help ensure states have access to adequate funds to effectively and predictably manage their state programs.

9.2  Governors’ Principles for the Children’s Health Insurance Program

Responsibility for the design and administration of the CHIP program rests with the states. Governors recommend the following key priorities to promote effectiveness and efficiency in administration of the CHIP programs and implementation of new provisions of the CHIP law.

• A cornerstone of the CHIP program is state flexibility. Maintaining this flexibility is critical for the program’s continued success and fiscal sustainability. New flexibilities will give states new options to provide health insurance to children.
• States are best-positioned to identify and adopt model practices in the areas of quality, access and cost containment that will best meet the needs of their CHIP program enrollees.
• Meaningful collaboration between state and federal partners should be used to develop performance bonus measures that are reasonable, operational and which reflect variation in state programs.
• The administrative burden of reporting requirements should be minimized, including through consultation with states to identify reasonable timelines, approaches to streamline forms, and procedures to ensure compatibility with existing systems as needed.
• Outreach and enrollment activities should be coordinated with state priorities and initiatives.
• States support flexibility to comply with citizenship documentation and identity verification. The federal government should work with states to further minimize the complexity and administrative burden of the requirement for CHIP and Medicaid applicants. this requirement also should be reviewed to ensure it does not result in denial of CHIP or Medicaid eligibility for U.S. born children.
• State program flexibility is critical to the success of the express lane eligibility option. This option must be designed so that states can utilize a unique combination of resources and approaches to enroll eligible children.
• Mandates in the CHIP program should be implemented in the least costly and burdensome manner for state programs.
• Improvements are needed to the state plan amendment process so that states can more efficiently adapt their program to meet the needs of eligible children and their families.
• State and federal partners must work together to harmonize conflicting or streamline duplicative requirements and focus limited state resources on priority issues across all initiatives to prevent fraud, waste and abuse and strengthen program integrity in Medicaid and CHIP programs.
• Design and implementation of new demonstration programs should leverage the experience of existing multidisciplinary state initiatives, including those focused on quality, electronic health records, and other aspects of health information technology.
• Meaningful coordination between state and federal agencies as well as employers and other stakeholders should help to reduce barriers to and facilitate the design, implementation and efficient operation of premium assistance programs.
  

Time limited (effective Annual Meeting 2009–Annual Meeting 2011).
Adopted Annual Meeting 1997; revised Annual Meeting 1999, Winter Meeting 2000, Annual Meeting 2001, Annual Meeting 2002, Annual Meeting 2003, Annual Meeting 2005, Annual Meeting 2007, and Annual 2009 (formerly Policy HR-15).