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CHIP turns 30: Program traces roots back to insuring kids of out-of-work Pittsburgh steelworkers

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.
Keith Srakocic
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.

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?”

Ciedro’s children are all adults now.

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

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.

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

Several people involved in the program’s creation and early years reflected to WESA on CHIP’s origins, lasting impact, and Western Pennsylvania roots.

An early ad for the program, featuring Mr. Rogers.

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.

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.

A flyer promoting the Caring Foundation's program.

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.

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.

Another CHIP promotion, from Highmark.

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.

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.

For more information about CHIP, go to

Kate Giammarise focuses her reporting on poverty, social services and affordable housing. Before joining WESA, she covered those topics for 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 can be reached at or 412-697-2953.