Eight-year-old Abigail Gabriel, center, hugs her mother, Erin, from her wheelchair as Pennsylvania Department of Human Services Acting Secretary Teresa Miller, Thursday, Dec. talks about the Children's Health Insurance Program, CHIP, during a news conference, Dec. 7, 2017, in Pittsburgh. The gathering marked the 25th anniversary of the Pennsylvania program to provide health insurance to uninsured children and teens who are not eligible for or enrolled in Medical Assistance. Miller, local health care providers, and families with children using CHIP spoke to call on Congress to reauthorize the program for children who rely on the health care coverage. Abigail has healthcare under Medicaid.
Kate is covering the impact of COVID-19 on the economy.
She covered poverty, social services and affordable housing at the Pittsburgh Post-Gazette for nearly five years; prior to that she spent several years in the paper’s Harrisburg bureau covering the legislature, governor, and state government.
She was part of the P-G staff that won the 2019 Pulitzer Prize for Breaking News Reporting on the mass shooting at the Tree of Life Synagogue in Pittsburgh. She has won numerous state and local awards for her reporting and was honored with a 2020 Keystone Media Award for her beat reporting on poverty.
She also previously reported for several newspapers in Ohio and covered the steel industry for a trade publication.
Keith Srakocic / AP Photo
Eight-year-old Abigail Gabriel, center, hugs her mother, Erin, from her wheelchair as Pennsylvania Department of Human Services Acting Secretary Teresa Miller, Thursday, Dec. talks about the Children's Health Insurance Program, CHIP, during a news conference, Dec. 7, 2017, in Pittsburgh. The gathering marked the 25th anniversary of the Pennsylvania program to provide health insurance to uninsured children and teens who are not eligible for or enrolled in Medical Assistance. Miller, local health care providers, and families with children using CHIP spoke to call on Congress to reauthorize the program for children who rely on the health care coverage. Abigail has healthcare under Medicaid.
Maureen Ciedro’s kids were enrolled in CHIP – Pennsylvania’s Children’s Health Insurance Program – back in the 1990s, when she was a cash-strapped single mother.
But even many years later, she can still recall the peace of mind the program brought her, knowing her kids had health insurance if anything should happen.
“When you are struggling and you have so many balls in the air, it’s nice to know that this is one thing that you can set aside and say, ‘Okay, that’s fine, that’s fine, we’re good on that.’”
It was particularly helpful, she recalled, in helping her feel it was okay for her kids to play sports and just generally run around – in other words, to be normal kids.
“When I think about my children and I think about that time in their lives, they’re wanting to run and play and jump and do sports and do gym things … When you don’t have insurance, you do have concerns. Because if something should happen, what will I do?”
CHIP provides insurance at no cost or low cost to kids in Pennsylvania. It covers children whose families earn too much to qualify for Medicaid, also known as Medical Assistance, which covers lower-income families.
Several people involved in the program’s creation and early years reflected to WESA on CHIP’s origins, lasting impact, and Western Pennsylvania roots.
Late night legislating
Former state Representative and state Senator Allen Kukovich, a Westmoreland County Democrat, had been working for years, starting in the 1980s, to pass a comprehensive set of health care bills.
Those bills had been languishing in the legislature, but several things came together, politically and legislatively, in 1991 and 1992 to pass the CHIP legislation, he said.
An early ad for the program, featuring Mr. Rogers.
First, getting the program funded involved some late-night Harrisburg budget maneuvering. During one of the Capitol’s many protracted state budget disputes, Kukovich and another legislator tucked a little-noticed provision into a budget bill to start the CHIP program, using a two-cents per pack tax on cigarettes to fund it.
“So all of a sudden I had $20 million for a program that didn’t exist,” Kukovich recalled.
Coming up with the financial means to start the program was important, but another factor was critical as well during this time, he said; the political winds were shifting on health care.
One key, Kukovich said, was Harris Wofford’s successful run for the U.S. Senate; Wofford had made health care a big campaign issue.
“The morning after that election …I got a call from The Philadelphia Inquirer asking me about, ‘What does this mean for my [health care] bill now?’ Which, of course, I didn’t have a clue, but it was an opportunity. And I said, ‘Well, this is the momentum we need…’ I did that routine,” Kukovich recalled with a chuckle.
Following some wrangling in the state Senate, the legislation went on to pass, and the bill creating CHIP was signed by then-Governor Robert P. Casey in December of 1992.
Origins in fall of the local steel industry
Kukovich and others modeled the design of the program on a charity health care program that already existed in Pittsburgh.
A flyer promoting the Caring Foundation’s program.
The Western Pennsylvania Caring Foundation for Children had started in the mid-1980s when thousands of local steelworkers were losing their jobs – and their health insurance. The program used community donations, with Blue Cross of Western Pennsylvania (a predecessor to Highmark) covering the 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 her kids health coverage through the Caring program. She credits the program with saving her son’s hearing; he had been in danger of hearing damage due to repeated ear infections as a young child.
“Fortunately, through the program, was able to get the medical care that he needed, the operation on his ears and so forth, that saved his hearing. And he’s a happy, 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 grow the program in the 1980s, sees several factors as key 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 did while you had coverage through your steel job,” said LaVallee, who today runs Variety – the Children’s Charity, which helps kids with disabilities.
LaVallee said the Caring Foundation’s program was not only cost-effective, but also popular and trusted, thanks to high-profile endorsements like ads and flyers featuring Mister Rogers.
Borrowing the structure of the program for CHIP – using an existing insurance company – also “enabled me to talk about not creating a new government program, but a public-private partnership,” Kukovich said.
CHIP goes national
In Pennsylvania, CHIP grew under both Republican and Democratic governors.
Another CHIP promotion, from Highmark.
It then became one of the handful of state programs the federal government looked to 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 and New Hampshire and Florida to use as a model for the National Children’s Health Insurance Program … So, Pennsylvania was absolutely a leader on this issue,” said Joan Alker, executive director at the Center for Children and Families at Georgetown University and an expert on CHIP.
Along with Medicaid – which also insures millions of kids – CHIP has been critical in reducing the number of uninsured children in the United States, she said.
Sometimes, your mornings are just too busy to catch the news beyond a headline or two. Don’t worry. The Morning Agenda has got your back. Each weekday morning, host Tim Lambert will keep you informed, amused, enlightened and up-to-date on what’s happening in central Pennsylvania and the rest of this great commonwealth.
