Medicare, Medicaid, and CHIP/SCHIP

Compare and contrast Medicaid, Medicare, and the Children’s Health Insurance
Program/State Children’s Health Insurance program (CHIP/SCHIP). Describe how
these programs are similar and different in terms of structure and financing. Select one
of these programs and imagine you are in a position to redesign that program. What
key policy issue is most important to address? What primary policy change would you
recommend for improvement? Explain and support your position with evidence.

Medicare, Medicaid, and CHIP/SCHIP
Comparison and Contrast

Medicare, Medicaid and Children’s Health Insurance Program (CHIP/SCHIP) are
programs designed by the federal government to help patients cater for their medical
expenses. They target the underprivileged and underserved communities and hence ensure
accessibility to healthcare. They limit the income of the individuals to ensure that the
beneficiaries are from low-income families and those with inadequate resources. CHIP was
also introduced to aid the families that were above the minimum requirements of Medicaid,
but the parents cannot afford coverage for the children as they are not covered by Medic Aid
(Burd, Brown, Puri, & Sanghavi, 2017) . On the other hand, they contrast by the individuals
and requirement criteria. Medicare guarantees healthcare coverage for individuals above 65
years of age and younger individuals with disabilities and is a form of insurance cover.
Medicaid was designed to cover low income and with inadequate resources from all ages and
is based on financial need. It also includes out-of-pocket expenses which are exempt for some
individuals, including those living in institutions (Millwee, Quinn, & Goldfield, 2018) . Some
families are not eligible for Medicaid but do not have adequate resources for private coverage
of their children. The funding is capped and also limits the number of children covered per

Similarities and Differences

The programs are similar in structure as they are established and administrated by
federal and state policies and statues which hence provide the oversight and guidelines of
implementation. Moreover, they are protected by the various policies which ensure that they
are sustainable and are not mismanaged or misused by multiple entities and stakeholders.
However, the programs differ in their structure as Medicaid and CHIP are funded by the
government to a certain extent and have out of pocket expenses (Millwee, Quinn, &
Goldfield, 2018) . On the other hand, Medicare is offered to older individuals above 65 years
and the younger groups who have pre-described disabilities and do not have out of pocket
expenses. Funding of the programs is through the federal government and various agencies
involved in the program’s implementation. They also guarantee public coverage and funded
through the federal government.

Key Issues and Policy Improvement

The programs are faced by critical issues which include inaccessibility of some of the
services offered with limitations on some of the other services provided due to the financial
capping. Moreover, some individuals view programs such as Medicare as an entitlement.
Thus, there is a need to ensure that the programs are clarified (Millwee, Quinn, & Goldfield,
2018) . Policy improvements to be made would include the barring of shifting and transferring
of funding from the federal to the state governments, which would lead to a reduction in the
number of services offered. Instead, the states and local governments should be encouraged
to augment the services provided by the Federal government (Burd, Brown, Puri, &
Sanghavi, 2017) . Furthermore, it would require the use of innovation and technology to drive
down health care costs and make it accessible to all.



Burd, C., Brown, N. C., Puri, P., & Sanghavi, D. (2017). Centres for Medicare and medic aid
services lens toward value-based preventative care and population health. Public
Health Reports, 132(1), 6-10.
Millwee, B., Quinn, K., & Goldfield, N. (2018). Moving towards paying for outcomes in
Medicaid. The Journal of Ambulatory Care and Management, 41(2), 88-94.