ABSTRACT
The Children’s Health Insurance Program Reauthorization Act (CHIPRA) was enacted as P.L. 111-3, in the opening days of the Obama administration. Its passage was preceded by a lengthy buildup and two developments that significantly affected the outcome. One was the August 17, 2009 letter to State Health Officials that stated that CMS would deny any future applications to cover children in families above 250 percent of poverty unless the state could certify that it had already enrolled 95 percent of the children below that level. 1 The other was President Bush’s vetoes of the first two versions of the reauthorization bill.
