42 U.S.C. § 1397aa

Purpose; State child health plans

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(a) PurposeExcept with respect to the rural health transformation program established in section 1397ee(h) of this title, the purpose of this subchapter is to provide funds to States to enable them to initiate and expand the provision of child health assistance to uninsured, low-income children in an effective and efficient manner that is coordinated with other sources of health benefits coverage for children. Such assistance shall be provided primarily for obtaining health benefits coverage through—(1) obtaining coverage that meets the requirements of section 1397cc of this title, or(2) providing benefits under the State’s medicaid plan under subchapter XIX,or a combination of both.(b) State child health plan requiredA State is not eligible for payment under subsection (a) or (g) of section 1397ee of this title unless the State has submitted to the Secretary under section 1397ff of this title a plan that—(1) sets forth how the State intends to use the funds provided under this subchapter to provide child health assistance to needy children consistent with the provisions of this subchapter, and(2) has been approved under section 1397ff of this title.(c) State entitlement

This subchapter constitutes budget authority in advance of appropriations Acts and represents the obligation of the Federal Government to provide for the payment to States of amounts provided under section 1397dd of this title.

(d) Effective date

No State is eligible for payments under section 1397ee of this title for child health assistance for coverage provided for periods beginning before October 1, 1997.

(Aug. 14, 1935, ch. 531, title XXI, § 2101, as added Pub. L. 105–33, title IV, § 4901(a), Aug. 5, 1997, 111 Stat. 552; amended Pub. L. 119–21, title VII, § 71401(b)(1), July 4, 2025, 139 Stat. 331.)Editorial NotesAmendments

2025—Subsec. (a). Pub. L. 119–21, § 71401(b)(1)(A), substituted “Except with respect to the rural health transformation program established in section 1397ee(h) of this title, the purpose” for “The purpose” in introductory provisions.

Subsec. (b). Pub. L. 119–21, § 71401(b)(1)(B), inserted “subsection (a) or (g) of” before “section 1397ee of this title” in introductory provisions.

Statutory Notes and Related SubsidiariesImplementation

Pub. L. 119–21, title VII, § 71401(c), July 4, 2025, 139 Stat. 332, provided that: “The Administrator of the Centers for Medicare & Medicaid Services shall implement this section, including the amendments made by this section [amending this section and sections 1397ee and 1397ff of this title], by program instruction or other forms of program guidance.”

References to SCHIP and State Children’s Health Insurance Program

Pub. L. 106–113, div. B, § 1000(a)(6) [title VII, § 704], Nov. 29, 1999, 113 Stat. 1536, 1501A–402, which provided that, in official communications concerning this subchapter, the terms “SCHIP” and “State children’s health insurance program” were to be used instead of “CHIP” and “children’s health insurance program”, respectively, was repealed by Pub. L. 111–3, title VI, § 612, Feb. 4, 2009, 123 Stat. 101.

Notes of Decisions

Cited in 9 cases (2 in the last 5 years), 2002–2024 · leading case: Shattuck v. Kalispell Reg'l Med. Ctr., Inc., 2011 MT 229 (Mont. 2011).

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Shattuck v. Kalispell Reg'l Med. Ctr., Inc., 2011 MT 229 (Mont. 2011). · cites it 4× “201(9) (2007) 9 provides that ‘CHIP eligibility and benefits are not an entitlement.”

State v. United States, 300 F. Supp. 3d 810 (N.D. Tex. 2018). “See 42 U.S.C. § 1397aa. Plaintiffs participate in CHIP, providing CHIP services and receiving CHIP subsidies.”

Oklahoma Chapter of the Am. Academy of Pediatrics v. Fogarty, 205 F. Supp. 2d 1265 (N.D. Okla. 2002). “§ 1396 , and the State Children’s Health Insurance Program ("S-CHIP”), "Title XXI,” 42 U.S.C. § 1397aa. Although eligibility and funding under Title XIX and S-CHIP are distinct, Oklahoma provides services to S-CHIP eligible children under its Title XIX program.”

Oklahoma Chapter of the Am. Academy of Pediatrics v. Fogarty, 366 F. Supp. 2d 1050 (N.D. Okla. 2005). “42 U.S.C. §§ 1397aa; 1397jj(e)(4). In providing S-CHIP coverage, states were permitted to expand their Medicaid program, to create a new program, or to use a combination approach.”

JULIA M. v. Scott, 498 F. Supp. 2d 1245 (W.D. Mo. 2007). “42 U.S.C. § 1397aa(a)(2); 42 C.F.R. § 457.”

Oklahoma Chap. of Amer. Aca., Pediat. v. Fogarty, 366 F. Supp. 2d 1050 (N.D. Okla. 2005). “42 U.S.C. §§ 1397aa; 1397jj(c)(4). In providing S-CHIP coverage, states were permitted to expand their Medicaid program, to create a new program, or to use a combination approach.”

Peacehealth St. Joseph Med. Ctr. v. State Of Wa, Dept. Of Revenue (Wash. Ct. App. 2019). “42 U.S.C. § 1397aa. The HCA administers CHIP.”

State of Florida v. Centers for Medicare & Medicaid Servs. (M.D. Fla. 2024). “§ 1396a(a) or 42 U.S.C. §§ 1397aa– 1397bb and submit the plan for approval.”

State Of Texas v. Becerra (E.D. Tex. 2024). “” 42 U.S.C. § 1397aa(a). Nothing cited gives CMS the authority to prohibit discrimination on the basis of gender identity—and effect the kind of sweeping social policy change the agencies attempt here.”

— 42 U.S.C. § 1397aa(a) — 2 cases

Shattuck v. Kalispell Reg'l Med. Ctr., Inc., 2011 MT 229 (Mont. 2011). “201(9) (2007) 9 provides that ‘CHIP eligibility and benefits are not an entitlement.”

— 42 U.S.C. § 1397aa(a)(2) — 1 case

JULIA M. v. Scott, 498 F. Supp. 2d 1245 (W.D. Mo. 2007). “42 U.S.C. § 1397aa(a)(2); 42 C.F.R. § 457.”

— 42 U.S.C. § 1397aa(b) — 1 case

Shattuck v. Kalispell Reg'l Med. Ctr., Inc., 2011 MT 229 (Mont. 2011). “201(9) (2007) 9 provides that ‘CHIP eligibility and benefits are not an entitlement.”

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