CHIP at 30: Pennsylvania Children's Health Insurance Program Marks Three Decades

CHIP at 30: Pennsylvania Children’s Health Insurance Program Marks Three Decades

Maureen Ciedro’s children were enrolled in CHIP – Children’s Health Insurance Program of Pennsylvania – in the 1990s when she was a cash-strapped single mother.

But even many years later, she still remembers the peace of mind the program gave her, knowing that her children had health insurance if anything were to happen.

“When you’re struggling and you have so many balls in the air, it’s nice to know that’s something you can put aside and say, ‘Okay, it’s okay, it’s okay, we are good at it.

It was particularly helpful, she recalls, in helping her feel that there was nothing wrong with her children playing sports and generally just running – in other words, running. to be normal children.

“When I think of my children and this time in their lives, they want to run, play, jump, play sports and go to the gym… When you don’t have insurance, you have worries. ‘Cause if something were to happen, what would I do?

Ciedro’s children are all adults now.

And Pennsylvania’s CHIP program is also an adult, so to speak – he turned 30 this month.

CHIP provides free or low-cost insurance to children in Pennsylvania. It covers children whose families earn too much to qualify for Medicaid, also known as medical assistance, which covers low-income families.

More than 130,000 children are now enrolled in CHIP statewide.

Several people involved in the creation and early years of the program spoke to WESA about the origins of CHIP, its lasting impact, and its roots in western Pennsylvania.

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Legislating late at night

Former State Representative and State Senator Allen Kukovich, a Democrat from Westmoreland County, had worked for years, beginning in the 1980s, to pass a comprehensive set of health care bills .

Those bills languished in the legislature, but several things came together, politically and legislatively, in 1991 and 1992 to pass the CHIP legislation, he said.

First, funding the program involved late-night budget maneuvering in Harrisburg. During one of the Capitol’s many protracted budget disputes, Kukovich and another lawmaker inserted a little-noticed provision into a budget bill to launch the CHIP program, using a tax of two cents per pack of cigarettes for the finance.

“So all of a sudden I got $20 million for a program that didn’t exist,” Kukovich recalled.

Finding the financial means to start the program was important, but another factor was also critical during this time, he said; the political winds were turning on health care.

One key, Kukovich said, was Harris Wofford’s successful run for the U.S. Senate; Wofford had made health care a major campaign issue.

“The morning after this election…I got a call from the Philadelphia Inquirer asking me ‘what does this mean for my [health care] charge now? Which, of course, I had no idea, but it was an opportunity. And I said, ‘Well, that’s the momentum we need…’I did that routine,” Kukovich recalled with a laugh.

After some wrangling in the state Senate, the legislation passed and the bill creating CHIP was signed into law by then-Governor Robert P. Casey in December 1992.

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Falling origins of the local steel industry

Kukovich and others modeled the program design on a charitable health care program that already existed in Pittsburgh.

The Western Pennsylvania Caring Foundation for Children was formed in the mid-1980s when thousands of local steelworkers lost their jobs – and their health insurance. The program used community donations, with Blue Cross of Western Pennsylvania (a predecessor of Highmark) covering administrative costs and matching donations.

When Christine Coles’ husband lost his job as a steelworker in Homestead in the mid-1980s, she was able to get health coverage for her children through the Caring program. She credits the program with saving her son’s hearing; he had been at risk of hearing damage due to repeated ear infections as a young child.

“Fortunately, through the program, he was able to get the medical attention he needed, ear surgery etc. which saved his hearing. And he is a happy and successful young man today. And I think that’s what we all want… We want our children to grow up healthy.

Charlie LaVallee, who helped develop the program in the 1980s, considers several factors critical to its success.

“It was an insurance program. So it wasn’t like going to a free clinic. So you still had access to all the doctors you saw while you were covered by your steel job,” said LaVallee, who now runs Variety – children’s charitywhich helps children with disabilities.

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LaVallee said the Caring Foundation program was not only profitable, but also popular and trusted, thanks to high-profile endorsements such as ads and flyers featuring Mister Rogers.

Borrowing the program structure for CHIP — using an existing insurance company — also “allowed me to talk about not creating a new government program, but a public-private partnership,” said Kukovich.

CHIP goes national

In Pennsylvania, CHIP grew under both Republican and Democratic governors.

It then became one of the few state programs the federal government addressed when creating the National CHIP Program, which was signed into law in 1997 by President Bill Clinton.

“They looked at the experience of states like Pennsylvania, New Hampshire, and Florida to use as a model for the National Children’s Medicare program…So Pennsylvania was absolutely a leader on this question,” said Joan Alker, executive director of the Center for Children and Families at Georgetown University and an expert on CHIP.

Along with Medicaid — which also insures millions of children — CHIP has played a vital role in reducing the number of uninsured children in the United States, she said.

For more information about CHIP, visit

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