CHIP Turns 30: Children’s Health Insurance Program Shows What Health Companies, Communities Can Accomplish Together

By Alexis Miller, Segment President for Government Business, Highmark Inc.

Thirty years ago, Highmark enrolled the first child in Pennsylvania in CHIP (Children’s Health Insurance Program)—a comprehensive, low-or-no-cost health insurance program that ensures our kids are protected. CHIP is a cornerstone of American health care today, providing an affordable coverage option for more than seven million kids in the U.S. and peace of mind for families.

While CHIP is all grown up—it’s a millennial!—it’s worth revisiting how this thriving program came to be. In the wake of economic hardship, stakeholders from across Pennsylvania rallied to make sure our kids’ health needs were met—and in the process, created a national model for children’s health care and cross-sector partnerships.

The collapse of the steel industry in the 1980s devastated Pittsburgh’s economy. Many workers lost health insurance coverage not just for themselves, but also for their spouses and children. Families were under immense pressure and faced heart-wrenching decisions. Food, rent and health care—some could only pick two. That’s not a choice that any family should have to make.

What we at Highmark heard above all else is, “please do something for our kids.” Health issues that could have been resolved or better managed with regular access to care worsened. The region’s economic crisis was leading to a health crisis.

Highmark partnered with more than 15,000 individuals, churches, unions, schools and other community organizations to raise funds and identify uninsured children. We brought together those groups and health care providers to offer services and design a first-of-its-kind offering: The Caring Program for Children.

The Caring Program for Children was a needs-based insurance program that provided the same level of care and access offered to other Blue Cross Blue Shield members. No child was excluded due to a pre-existing condition. Communities stepped up by raising funds for uninsured children in their own neighborhoods. And we stepped up by matching those funds dollar-for-dollar, and by covering the administrative costs of the program. It was the first health insurance program in the nation to cover at-risk kids.

We also got creative. Fred Rogers, of “Mister Rogers’ Neighborhood” fame, graciously supported the effort. He lent credibility to our effort to help families in distress. This program really was about helping your neighbors. The Pittsburgh Steelers, a beacon of hope for the region through difficult times, partnered with us to promote the programs and raise funds.

Other Blue Cross Blue Shield health plans from across the country took note of our region’s success. They understood that their local communities had some of the same unmet health needs and that The Caring Program offered a proven model. We were able to show that opening the doors to the health care system decreased unmet medical care, improved health outcomes, and ultimately enhanced both the economy and quality of life in the region.

The Caring Program evolved into a coalition of more than 20 other Blues plans serving kids across the country. But we knew that we could make an even greater impact on the lives of children and families in Pennsylvania. So, we partnered with legislators and community organizations to create a sustainable model for a statewide children’s health insurance program. We worked together to design benefits and create public-private partnerships. We took the learnings and successful model of The Caring Program and scaled it. And in 1993, Highmark enrolled the first child into CHIP in Pennsylvania. Pennsylvania led the way in caring for at-risk children, and the rest of the nation followed.

Healthy kids make healthy adults. When children have strong health insurance coverage, it sets them on a course for lifelong wellness and success. It frees them to be their best, and allows them to grow and develop physically, socially and emotionally. For families, there’s relief in knowing that their children are protected.

The leaders involved in The Caring Program for Children had to do something that had never been done before. The Caring Program served as inspiration for providing high-quality, affordable health care to children across Pennsylvania and, later, across the country. It provided a pathway for the national CHIP program.

The Caring Program demonstrated that when you listen to the concerns of the community, and involve them in creating the solution, systemic change is possible. And it showed how the public and private sectors can work together to create solutions to major problems.

We are proud to have played a leading role in The Caring Program, and in building CHIP into what it is today. CHIP has been strengthened over the years, offering additional supports to children with complex health conditions, and most kids are eligible. CHIP is a source of pride for Highmark—which insures more than 15,000 kids across 62 counties in Pennsylvania through our Highmark Healthy Kids program—and for all Pennsylvanians. It’s an example of putting kids and families first.

As Pennsylvania’s CHIP program blows out the candles, its creation and staying power show that when we partner with the communities that we proudly serve, anything is possible. And, with Medicaid redetermination resuming after the end of the COVID-19 public health emergency, CHIP remains a vital program. CHIP will be a safety net for some children in families who may no longer qualify for Medicaid coverage and do not receive insurance from another employer-based or government program. CHIP was there for kids and families 30 years ago in a time of need, and it’s there for them today.