Skip to main content

State Children'S Health Insurance Program


The Balanced Budget Act of 1997 (Public Law 105-33) established the State Children's Health Insurance Program (SCHIP) as Title XXI of the Social Security Act. This legislation, which involved the largest expansion of children's health insurance coverage in over thirty years, enables states to provide health insurance coverage to low-income children under age nineteen who are uninsured and ineligible for Medicaid.

Not since the enactment of Medicaid has there been a greater investment in children's health care in the United States. Title XXI provided over $40 billion in federal grants to states over a ten-year period. States were required to contribute a defined share of funds in order to obtain federal matching funds.

This legislation provided states flexibility in how they design their program. States can choose one of three approaches: (1) expand the current Medicaid program, (2) create or expand a separate state children's health insurance program, or (3) use a combination of both approaches. The majority of states created a non-Medicaid SCHIP program for at least some of their SCHIP-eligible children. Fifteen states created a non-Medicaid SCHIP program only, and nineteen states created a state program in combination with a Medicaid expansion. The remaining nineteen states used SCHIP funds to expand Medicaid only.



American Academy of Pediatrics. State Approaches to Title XXI. ElkGrove Village, IL: American Academy of Pediatrics, 2000.

Beth K.Yudkowsky

Cite this article
Pick a style below, and copy the text for your bibliography.

  • MLA
  • Chicago
  • APA

"State Children'S Health Insurance Program." Child Development. . 17 Jun. 2019 <>.

"State Children'S Health Insurance Program." Child Development. . (June 17, 2019).

"State Children'S Health Insurance Program." Child Development. . Retrieved June 17, 2019 from

Learn more about citation styles

Citation styles gives you the ability to cite reference entries and articles according to common styles from the Modern Language Association (MLA), The Chicago Manual of Style, and the American Psychological Association (APA).

Within the “Cite this article” tool, pick a style to see how all available information looks when formatted according to that style. Then, copy and paste the text into your bibliography or works cited list.

Because each style has its own formatting nuances that evolve over time and not all information is available for every reference entry or article, cannot guarantee each citation it generates. Therefore, it’s best to use citations as a starting point before checking the style against your school or publication’s requirements and the most-recent information available at these sites:

Modern Language Association

The Chicago Manual of Style

American Psychological Association

  • Most online reference entries and articles do not have page numbers. Therefore, that information is unavailable for most content. However, the date of retrieval is often important. Refer to each style’s convention regarding the best way to format page numbers and retrieval dates.
  • In addition to the MLA, Chicago, and APA styles, your school, university, publication, or institution may have its own requirements for citations. Therefore, be sure to refer to those guidelines when editing your bibliography or works cited list.