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Medicaid Expansion
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State Program
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Alabama
Approved Phase I
1/30/98
Approved Phase II
8/18/98
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Phase I-Medicaid expansion providing new coverage to children age 15
through 18 in families with incomes up to 100% FPL and accelerated enrollment.
Status: Plan approved by HCFA on Jan 30, 1998. Began Feb 1, 98.
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Phase II-Private insurance program, AL-Kids, children through age 18
up to 200% FPL. Benchmark for benefits is the HMO with largest commercial
enrollment. To be administered through two insurance vendors. Twelve mos
continuous eligibility. Above 150% FPL premiums are $60/child/yr and copay
with max of $500/yr.
Phase III: 2nd amendment proposes a plan to offer additional services
via ALL Kids to children with special health care needs through the agencies
that currently provide care to these children (i.e. Title V agency, etc..)
Status:
Status: Phase II Began Sept 1, 98. 2nd amendment approved on 9/28/99.
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Alaska
Approved
12/11/98
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Medicaid expansion to children through age 18 in families with incomes
up to 200% FPL. Twelve mos of continuous eligibility
Status: Bill H 369 authorizing expansion on 7/1/98. Gov proposal.
Expansion implemented on March 1, 1999.
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Arizona
Approved 9/18/98
Amendment submitted
2/23/99
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KidsCare, subsidized insurance for children through age 18 in families
with incomes up to 150% FPL. AZ Health Care Cost Containment System (state
Medicaid agency) will administer. State employee plan benefits package.
Eligible children can receive direct services from qualifying health centers
and hospitals and pay on sliding fee scale. Direct services in first year
will be state-funded. Mental health services reduced from Govs original
proposal, more medical coverage, and wider choice of providers beyond
Medicaid providers.
Original plan proposed expansion of KidsCare on July 1, 1999 up to 175%
FPL.
2nd plan amendment accelerated expansion to 200% as of October 1, 1999.
Also, plan imposes premiums on enrollees starting 10/1/99.
Status: S 1008 d enacted to establish all phases. Phase I implemented.
2nd plan amendment approved 8/23/99. 3rd amendment submitted on 9/27/99.
Bill S 1357 authorizes KidsCare expansion to 200% FPL.
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Arkansas
Phase I Approved
8/6/98
Phase II Amendment Submitted
12/4/98
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Phase I - Medicaid expansion to accelerate eligibility of children age
15 up to 100% FPL.
Phase II-Convert ARKids First Program enrollees to Title XXI.
Status: Plan submitted to HCFA on May 12, 98. Gov proposal. Phase I to
effective July 1, 98.
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California
Approved
3/24/98
Amendment Approved
6/26/98
Second Amendment
Submitted
1/8/99
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Medi-Cal modifications include raising coverage to 100% FPL for ages
14 through 18, asset test waived, simplified application (pending federal
approval)
Status: Plan approved by HCFA on Mar 24, 1998. Bill S 903 enacted authorizing
expansion. Program began July 8, 1998. (7/31/98)
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Healthy Families program, subsidized insurance - coverage to children
age 7 through 18 with incomes between 100 and 200% FPL, ages 2-6 between
133 and 200% FPL. State employee benefits package with comprehensive dental
and vision coverage, screening and initial treatment services through
Child Health and Disability Prevention program; and treatment services
for severely ill children through non-managed care delivery system. Cost
sharing and monthly premiums on sliding scale.
1st amendment narrows the income disregards in the original plan approved
by HCFA.
2nd amendment proposes to increase the application reimbursement fee to
$50 per successful application. The amendment also exempts from copayments
Indian children enrolled in Healthy Families who use Indian Health Service
funded clinics.
3rd amendment proposes
Bill AB 1107 expands Healthy Families to include families between 200%
and 250% of poverty. Also allows coverage of qualified aliens under Healthy
Families, using state funds only. Signed by Governor Davis on 7/22/99
Status: Bill A 1126 enacted authorizing program (6/26/98)
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Colorado
Approved Phase I
2/18/98
Amendment Submitted
2/1/99
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Expansion of existing Child Health Plan (renamed to Child Health Plan
Plus), subsidized insurance program, and creation of new Childrens
Basic Health Plan, subsidized insurance program.
Phase I-Child Health Plan Plus-coverage expanded to all counties to children
from birth through age 17 with incomes below 185% FPL under same Medicaid
provider network. Benefits are outpatient services and acute and chronic
illness.
Phase II-Childrens Basic Health Plan will have same eligibility
but will have premiums based on sliding fee scale premiums. Plan for children
and parents. Benefits are based on COs Standard Plan. Buy-in will
be available to families with incomes above 185% FPL at full cost. More
sophisticated collections and HMO payment system, and enhanced managed
care quality oversight system.
Status: Bill H 1304 authorizing both phases was enacted in 97 session.
Phase I began on June 15, 1998.
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Connecticut
Approved 4/28/98
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Healthcare for Uninsured Kids and Youth (HUSKY)-Part A-accelerated Medicaid
coverage/eligibility [phase-in for adolescents] and outreach to 185% FPL
age 14 through age 18. Twelve mos continuous eligibility. A single entity
will market, enroll, administer, & provide outreach for both plans.
Status: Plan approved by HCFA on Apr 28, 98. Bill authorizing HUSKY enacted
4/27/97. Program began June 10, 98.
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Healthcare for Uninsured Kids and Youth (HUSKY)-Part B, subsidized insurance,
for children between 185% FPL up to 300% FPL (with income disregards).
No premiums required of children in families with incomes below 235% FPL
and prorated premiums required to those above 235% FPL (before income
disregards) with maximum limit. Coverage open to children above 300% at
full cost. Twelve months continuous eligibility. A single entity will
market, enroll, administer, & provide outreach for both plans.
Two supplemental health insurance programs, HUSKY Plus (one for children
with intensive physical health needs, another for children with intensive
behavioral health needs), are also avail. to those enrollees of the HUSKY
Part B plan whose needs cannot be met with the basic benefit package of
Part B.
Status: Plan approved by HCFA on Apr 28, 98. Bill authorizing HUSKY and
HUSKY Plus enacted 4/27/97. Program began June 10, 98.
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Delaware
Approved 9/1/98
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DE Healthy Children program, a Medicaid look-alike program for children
up to 200% FPL with Medicaid managed care-like benefits. Proposal to partner
with employers to allow those with incomes up to 300% FPL to buy into
program being considered.
Status: . S 380 enacted that authorizes the DE Health Care Commission
to establish a program for uninsured children.
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District of Columbia
Approved 9/17/98
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Medicaid expansion up to 200% FPL through age 18. Twelve month continuous
eligibility. Carve-outs for mental health and children with special health
care needs. Copays: $2 for prescriptions and up to $5 copay for glasses.
Status: Approved by the Control Board.
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Florida
Approved 3/5/98
1st Amendment Approved
9/8/98
2nd Amendment Submitted
12/2/98
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Medicaid expansion (part of KidCare) to increase coverage to children
ages 15 through 18 up to 100% FPL. Presumptive eligibility not included.
Plan to seek a Medicaid waiver that would match dollars for the expansion
of an existing program that provides services to pregnant women, at-risk
infants and young children from birth to age 3 with family incomes up
to 200% FPL.
Proposed amendments to Title XXI plan: Continuous eligibility for children
through age 18 for six mos as of July 1, 98. Children under age 5 continuous
eligibility extended to twelve mos as of Jan 1, 99.
Status: Bill H 4415 enacted on 5/28/98 that authorizes amendments to approved
plan, creating the FL Kidcare program.
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Expansion of FL Healthy Kids program (part of KidCare) for age 5 through
18 for all children enrolled in school in families with incomes up to
185% FPL. Expanded to more counties (when they apply to participate).
Subsidized premiums with copays for certain services. Families with incomes
above 185 % FPL can buy into program at full cost. May add options to
benefit package for added cost. Supplemental dental and behavioral health
services also available. Special health care services to children who
are medically involved, complex, or fragile are covered through Childrens
Medical Services network. Program administration is by non-profit organization
created by state legislature services and delivered through state-licensed
managed care plans.
Approved amendment to Title XXI plan: To Healthy Kids program
expansion to 200% FPL and additional behavioral health benefits; another
separate state program, Medikids a Medicaid look-alike program
for children; an employer-sponsored group health insurance, and a program
for children with special health care needs through age 18 administered
by Childrens Medical Services. All programs will have 6 mos of continuous
eligibility for children through age 18 as of July 1, 98.
2nd amendment submitted proposes an employer sponsored premium assistance
program.
Status: Bill H 4415 enacted on 5/28/98 that authorizes the proposed amendments
to approved plan, creating the FL Kidcare program.
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Georgia
Approved 9/3/99
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Subsidized insurance program, PeachCare for Kids, for children through
age 18 between 100% and 200% FPL. Presumptive eligibility. Amount of premiums
and co-pays to be determined. Administered by Dept of Medical Assistance.
Medicaid benefits except non-emergency transportation and targeted case
management. No copays or premiums for children under age six. Premiums
required for other children.
Status:Bill S 410 authorizing program enacted.
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Hawaii
Approved 1/19/99
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Three phase Medicaid expansion:
Phase I: coverage to children 1 through 6 in families with incomes up
to 185% FPL.
Phase II: phased in coverage up to 185% FPL through age 18 in 2 year age
increments (e.g. 6-7 year olds, 8-9 year olds, etc..)
Phase III: coverage to children birth through age 18 up to 200% FPL.
Status: Dept of HHS, led by QUEST (Section 1115 waiver program) adminstrator,
expected to submit request for funding of all three phases to legislature
in 1999 session. Implementation pending legislative appropriation.
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Idaho
Approved 6/15/98
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Medicaid expansion to increase coverage through age 18 in families with
incomes up to 150% FPL.
Status: Bill H 799 enacted authorizing expansion to 150%FPL. Plan was
amended to reflect authorizing legislation, amending eligibility from
160% FPL to 150% FPL.
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Illinois
Approved Phase I
4/1/98
Amendment Phase II Submitted
11/10/98
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Phase I-Medicaid expansion for pregnant women and infants up to 200%
FPL and children ages 6 through 18 up to 133% FPL. Voluntary managed care
program, Responsible Choice.
Status: Began on Jan 5,1998. Enrollment ongoing.
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Amendment Phase II-KidCare--for children through age 18 between 133%
and 185% FPL. Medicaid look-alike program. Medicaid provider network and
Medicaid provider reimbursements. Voluntary HMO enrollment. Premium assistance
through reimbursements will be given to those who have access to employer-sponsored
insurance. Copay for most services on sliding scale for all income levels
and monthly premiums for families only with incomes between 150% and 185%
FPL. Annual max for copays will be $100. Twelve mos continuous eligibility
despite change in family income or size.
Status: Legislature enacted HB 705 authorizing Phase II. Program began
August 1998. State providing services with state funding, pending HCFA
approval.
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Indiana
Approved Phase I
6/26/98
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Phase I-Medicaid expansion to children through age 18 up to 150% FPL.
This will be initial approach and short-term state plan. Presumptive and
continuous eligibility provisions are yet to be determined.
Status: . Bill S 19 enacted authorizing phase I. Expected start date
is Sept 1, 1998.
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Phase II - Separate state program for children through age 18 between
150% FPL and 200% FPL.
Status: Bill H 1001 establishes program. State must submit plan amendment
to HCFA.
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Iowa
Phase I Approved 9/1/98
Phase II Amendment Approved
6/16/99
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Medicaid expansion for children age through 18 and in families with incomes
up to 133% FPL.
Status:Program began July 1, 1998.
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Phase II Separate insurance program, Iowa Kids-for children through age
18 in families with incomes between 133% and 185% FPL. Newly created board
will determine implementation, benefits package, enrollment process, level
of premiums. Twelve mos continuous eligibility and presumptive eligibility.
Six months waiting period. Premiums and copays for incomes between 150%
and 185% FPL.
Status: Bill H 2517 signed by Gov to establish program. Program implemented
on Jan 1, 1999. Plan amendment approved on June 16, 1999.
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Kansas
Approved 9/1/98
Amendment Submitted
4/1/99
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Private insurance program for children through age 18 up to 200% FPL
(part of new program HealthWave). Kan Be Health (EPDST) benefits
package (including mental health and dental) proposed. Managed care delivery
and cost sharing. Capitated reimbursement arrangement. Presumptive eligibility
for certain children (i.e. Medicaid, SSI benefits lost, free/ reduced
lunches eligible). 12 mos continuous eligibility. Dept of Social and Rehab
Services will administer plan (including contract negotiations with providers
and payers). Outreach will be contracted out. Six mos uninsured period
Status: Legislators passed bill S 424 authorizing separate program. Program
implemented on Jan 1, 99.
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Kentucky
Approved 11/25/98
Amendment Submitted
6/7/99
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Phase I: Medicaid expansion to children ages 14 through 18 up to 100%
FPL.
Phase II: Medicaid expansion to children through age 18 up to 150% FPL.
Status: Bill S 128 enacted to authorize Medicaid expansion and separate
state program. Phase I Medicaid expansion implemented July 1, 1998. Phase
II expansion to begin July 1, 1999.
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Phase III: Separate state program, K-CHIP, added on top of the Medicaid
expansion from 150% - 200% of poverty. Program to be administered by the
Medicaid agency(Dept of Public Health) and benefit package will be a Medicaid
look-alike package.
Status: Bill S 128 enacted to authorize separate state program and Medicaid
expansion. Proposed program implementation date is November 1, 1999.
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Louisiana
Approved 10/20/98
Amendment approved 8/27/99
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Phase I-Medicaid expansion for children through age 18 up to 133% FPL
Program named LaCHIP.
Phase II: Governor's budget includes Medicaid expansion to 150% FPL.
Amendment authorizes expansion.Implemented in October 1999.
Status: Gov signed bill S 78 a authorizing expansion. Budget bill in
1999 includes appropriation for further expansion to 150% FPL. Phase I
implemented on 11/1/98. Phase II implemented on 10/1/99.
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Maine
Approved 8/7/98
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Medicaid expansion for children through age 18 in families with incomes
up to 150% FPL. Six mos continuous eligibility.
Status: BillH 1595 authorizing expansion and Cub Care.
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Subsidized insurance program, Cub Care-for children in families with
incomes between 150% and 185% FPL. Sliding scale premiums are to be included.
Buy-ins for up to 18 mos to be available to families whose income increases
beyond eligibility. No copayments or deductibles required. Six mos continuous
eligibility.
Status: Bill H 1595 authorizing Cub Care and expansion approved.
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Maryland
Phase I Approved
7/31/98
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Phase I (part of MDs Childrens Health Program)- Expansion
of Medicaid managed care program, HealthChoice - increasing coverage of
children through age 18 up to 200% FPL. Three month uninsured waiting
period. Six mos continuous eligibility. Mail-in application will be developed.
Status:. Gov signed bill S 85 authorizing Phase I and II. Govs
proposal. Amended Section 1115 Waiver will be submitted to HCFA for Phase
I. Began July 1, 1998.
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Phase II (part of MDs Childrens Health Program)- On or before
July 1, 1999 children in families with incomes between 185% and 200% FPL
will be required to enroll in employer sponsored insurance plan, when
available. Premiums (not to exceed HealthChoice costs) will be paid to
employers by the Dept of HMH. Premiums between 1% - 2% of family income
required also.
Status: Bill S 85 enacted authorizing Phase I and II
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Massachusetts
Approved
5/29/98
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Medicaid expansion, MassHealth-expanding coverage of children through
age 18 from 133% FPL® 150% FPL. Expansion plans
to increase pregnant women coverage from 185% FPL®
200% FPL. Presumptive eligibility.
Status:Enrollment ongoing.
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New subsidized insurance program, MassHealth Family Assistance plan-for
children through age 18 in families with incomes between 150% and 200%
FPL. Cost sharing between 1%-2% will be required. Premium assistance will
be available to purchase employer dependent coverage. Benefits package
will be similar to federal employees benefits plan.
Status: Enrollment ongoing.
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Michigan
Phase I Approved 4/7/98
Phase II Amendment Approved
6/26/98
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Phase II: Medicaid expansion to children through age 18 up to 150% FPL.
Status: Gov signed bill H 5532 authorizing program.Began in May, 1998.
Enrollment ongoing.
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Phase I: MIChild program, subsidized insurance -
Coverage to children under 200% FPL through age 18. Program to be administered
through existing health plans and networks. Monthly premiums required
with max of $192/yr & $5/family/mo. Benchmark benefits package: State
employee plan. Program will be payor of last resort for special needs
children. Twelve mos continuous enrollment. Six mo residency requirement.
Joint and simplified application for all programs, and integrated enrollment
process will be developed; outreach coordination with Maternal and Child
Health personnel in Dept of Community Health.
Amendments: Twelve mos lock-in enrollment, no copay and premiums will
not vary by number of children in family (will stay fixed at $5/family/mo.)
Status: Gov signed bill H 5532 authorizing program. Enrollment ongoing.
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Minnesota
Approved
4/29/98
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Medicaid expansion to MinnesotaCare to children under age 2 in families
with incomes between 275% and 280% FPL.
Status: Bill S 3346 enacted authorizing expansion. (7/15/98)
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Phase II - Subsidized insurance program for families with incomes up
to 275% FPL who have access to employer-subsidized insurance coverage.
Status: Legislature gave authorization to Dept to develop this program
under S 3346. Amendment not yet submitted
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Mississippi
Phase I Approved
10/26/98
Phase II Amendment Approved
2/10/99
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Phase I: MS Children's Health Insurance Program - temporary plan - Medicaid
expansion to children through age 18 up to 100% FPL.
Status: S 2174 enacted on 4/20/98 authorizing expansion and separate
state program. Children's Health Insurance Program Commission proposal.
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Phase II: MS Children's Health Insurance Program, a separate state program
for children through age 18 up to 133% FPL. State employees' benefits
package will be benchmark. Twelve mos continuous eligibility. Simplified
application process.
During 1999 session, legislature passed H 976 that expands CHIP to 200%
FPL.
Proposed start date for CHIP program is January 1, 2000.
Status: S 2174 enacted on 4/20/98 authorizing expansion and separate
state program. Children's Health Insurance Program Commission proposal.
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Missouri
Approved 4/29/98
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Amended Section 1115 waiver approved by HCFA (integrating SCHIP and states
MC+ Medicaid program) that would expand coverage to uninsured children
through age 18 and up to 300% FPL (with income disregards), uninsured
children regardless of income in Chapter I school districts. Benefits
package modified to exclude non-ER transportation services. Six month
waiting period. Copays based upon sliding scale.
Amendments include premiums and for children in families with incomes
between 226% and 300% FPL there will be requirements to show proof of
having no prior access to insurance.
Status: Bill S 632 enacted after plan was approved by HCFA. Enrollment
ongoing.
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Montana
Approved 9/11/98
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Phase I-Expansion of Caring program, small private insurance program
to children through age 18 up to 150% FPL (gross income). No asset test.
Benefits included are inpatient, outpatient hospital services, mental
health and substance abuse treatment, hearing and vision exams. Children
have choice of FFS plan or HMO plan contingent on area residing. Enrollment
fee per child required from families with incomes up to 100% FPL; another
fee per child for families with incomes up to 150% FPL. No copay. Administered
by Health Policy and Services Div of Dept of Public Health and Human Services
(PHHS).
Status: Bill S 81 enacted on May 6, 1999, establishes separate state
program. Limited enrollment began October 1998. Statewide enrollment proposed
to begin Fall 1999.
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Nebraska
Approved 8/7/98
Phase II Amendment Approved
10/13/98
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Medicaid expansion
Phase I increases coverage to adolescents in families with incomes up
to 100% FPL.
Phase II increases coverage to children in families up to 185% FPL. Includes
12 months of continuous eligibility.
Status: Bill L 1063 passed authorizing expansion.
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Nevada
Approved
8/13/98
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Nevada Check Up, subsidized insurance for children through age 18 in
families with incomes up to 200% FPL. Service delivery through HMOs. Short
application form available through schools, Family Resource Centers, Family-to-Family
Program. Twelve mos continuous eligibility. SCHIP program eligibility
determinations will be done annually and Medicaid eligibility will be
reviewed monthly. Comprehensive coverage will include dental, vision and
hearing services, and Rx, and copay for each for incomes above $24,000.
Sliding scale premiums included. Change from original plan submitted requested
by HCFA: asset tests will be required from families of four with incomes
greater than $21, 800 and assets of $3,300 or less.
Status: Enrollment ongoing.
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New Hampshire
Submitted
Phase I & II
6/11/98
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Phase I-Medicaid expansion to be integrated with pending Section 1115
waiver for children up to age 1 in families with incomes up to 300% FPL.
Status: Plan submitted to HCFA on May 29, 98. Div of Human Services proposal
in conjuction with separate state program. Will be presented to Gov and
legislature and subject to public review process. Began May 1, 98. (6/1/98)
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Phase II-Subsidized insurance program for children age 1 through 18 in
families with incomes between 185% and 300% FPL. Program administered
through partnership with Dept of HHS and Healthy Kids Corp. Emphasis on
perinatal care coverage for pregnant adolescent girls not served by Healthy
Kids Corp. Monthly premium per child and copay on office visits, Rx, non-emergency
ER use.
Status: Plan submitted to HCFA on May 29, 98. Div of Human Services proposal
in conjuction with Medicaid expansion. Will be presented to Gov and legislature
and subject to public review process. Expected to be begin Jan 1, 99.
(6/1/98)
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New Jersey
Approved
4/28/98
Amendment Approved
5/7/99
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Medicaid expansion (part of Kidcare program) will raise coverage for
children through age 18 in families with incomes up to 133% FPL.
Status:. Signed legislation S 2269 Dec 23 to establish program. Medicaid
expansion to begin on Jan 1, 1998.
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KidCare program, subsidized insurance, for children through age 18 whose
families have incomes between 133% FPL and 185% FPL. Will have less benefits
than Medicaid. Eligibility requirements: no insurance within past year.
Above 150% FPL required to pay a sliding scale monthly premium and copayments.
Amendment expands KidCare eligibility to 350% FPL for children through
the age of 18.
Status: Gov signed legislation S 2269 Dec 23, 1998to establish program.
S 1758 expands program to families up to 350% FPL. Expansion to 350% FPL
began July 1, 1999.
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New Mexico
Approved Phase I
1/1/99
Amendment Submitted
4/16/99
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Phase I-Medicaid expansion for children through age 18 in families with
incomes up to 235% FPL with additional wrap- around services, dual funding
option, family coverage. Enrollment of children in families with incomes
up to 185% FPL emphasized. Presumptive and twelve mos continuous eligibility
included.
Status: Gov signed bill S 132 authorizing expansion. (5/19/98)
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Amendment Phase II-Objectives are to implement prevention and intervention
services, a voluntary universal home visiting program for first-time mothers
up to two years, early intervention developmental services, behavioral
health identification, assessment management system provision, crowd-out
provisions for employers and employees, special application process and
services delivery considerations for Native American children.
Status:Gov signed bill S 132 authorizing separate program. Phase II implementation
yet to be determined. This phase will require application for waivers.
(5/19/98)
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New York
Approved Phase I
4/1/98
Amendment Submitted
4/1/99
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Phase II-Medicaid expansion to children through age 18 in families with
incomes up to 133% FPL once 50% of Medicaid eligible children are enrolled
in Medicaid managed care program. Twelve mos continuous eligibility for
Medicaid eligible children even if their family's income exceeds eligibility
levels while enrolled.
Note: Bill S 7843 scaled back eligibility level originally authorized
by Bill A 10767.
The amendment expands Medicaid coverage to children ages 15-18 up to
100% FPL
Status: Bill A 10767 passed authorizing expansion and Child Health Plus.
Was not included in plan submitted to HCFA. Eligibility level amended
from original bill through Bill S 7843 on 6/18/98.
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Phase I-Expansion of Child Health Plus program, subsidized insurance,
for children through age 18 in families with incomes up to 185% FPL (net
income). Program has been a government-private insurers partnership with
managed care coverage.
Phase II- Increase coverage to children in families with incomes up to
230% FPL and to 250% FPL (gross income) by July 1, 2000. Reduces monthly
premiums those between 160% and 222% FPL to $9/child/month.. Premium contributions
higher for incomes between 222% and 230% FPL (gross income) are $13/child/month.
Eliminates all copay requirements for all services. Creates "smart
card" program that would have all immediate and important medical
info. Develop local public education, outreach, and enrollment strategies
for Title XXI and XIX.
Amendment: Expands Medicaid elgiibility to 100% for children ages 15-18
years. Expands benefits under the CHPlus program.
Status: Bill A 10767 passed authorizing Child Health Plus and Medicaid
expansion. Amendments authorized through Bill S 7843 on 6/18/98. (6/26/98)
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North Carolina
Approved
7/14/98
Amendment Approved
1/19/99
2nd amendment Approved
6/23/99
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State program to children in families with incomes up to 200% FPL through
age 18. It will be administered by the State Employees Health Plan
(SEHP) and Dept of HHS. Same benefits package plus limited dental, vision,
and hearing services. Children with special health care needs will have
Medicaid benefits package except for long term care. Respite care only
for emergencies. Tax credit (not funded by Title XXI funds) for families
who pay for dependent children. Six month waiting period. Buy-in for children
above 200% FPL up to 225% FPL at full premium cost for one yr. Copays
and enrollment fees applies to those with incomes above 150% FPL with
a max enrollment fee of $100/yr.
Amendment: Waiting period (period of uninsurance) reduced to 60 days
from 6 months.
Amendment II: Allows health services to be delivered in school based clinic
Status: Plan approved by HCFA on July 14, 98. Gov signed bill S 2 a.
Legislatures compromised approval authorized new program. State
officials proposal. Enrollment expected to begin Oct 1, 98. (7/14/98)
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North Dakota
Approved Phase I
10/9/98
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Phase I-Medicaid expansion for children age 18 up to 100% FPL.
Status: Enrollment ongoing.
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Phase II-New private program for children through age 18 up to 140% FPL.
Status Bill S 2012 signed by Governor on April 23, 1999. Program implemented
on 10/1/99.
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Ohio
Approved
3/23/98
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Medicaid expansion for children through age 18 in families with incomes
up to 150% FPL.
Status:Enrollment ongoing. Legislature is considering bills that would
expand Medicaid to children up to 200% FPL.
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Oklahoma
Approved Phase I
5/26/98
Amendment Approved
3/25/99
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Phase I-Expand Medicaid to children ages 15 through 17 with family incomes
up to 185% FPL, phasing in each age group by the year 2000. (Children
from birth through age 14, those born on or after October 1, 1983, are
currently covered up to 185% FPL.)
In November 1998 Oklahoma accelerated the Medicaid expansion to children
through age 17 up to 185% FPL. Amendment approved for expansion on 3/25/99.
Phase II-further Medicaid expansion to 250% FPL with cost sharing. (House
bill to eliminate cost sharing option vetoed 5/29/98).
Status:Bill S 639 enacted authorizing phase I last legislative session
'97 as part of pre-Title XXI Medicaid expansion. Phase II still in development
stages.
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Oregon
Approved Phase I
6/12/98
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Phase I-Expansion of new subsidy program, Family Health Insurance Assistance
Program, for children through age 5 in families with incomes between 133%
to 170% FPL; and for children age 6 through 18 in families with incomes
between 100% and 170% FPL. Benefits will be same as Medicaid Section 1115
plans.
Status: In 1997, legislature passed Bill S 5545 authorizing Medicaid
expansion for children. 1998 emergency interim board authorized using
those funds for CHIP program. Further legislation needed to authorize
adminstering agency.
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Pennsylvania
Approved
5/28/98
Amendment Approved
10/29/98
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Existing state Childrens Health Insurance Program (CHIP) for children
through age 16 up to 185%. Subsidized coverage for children through age
5 between 185% - 235% FPL.
Amendment: Expand free coverage to all children through age 18 up to 200%
FPL. Subsidized coverage (with sliding scale premiums) for all children
through age 18 in families with incomes between 200% - 235% FPL (covered
by state funds only.) Benefits package includes full inpatient and outpatient
services coverage.
Status: Bill S 91 authorized program. On April 8, 1999, Governor Ridge
announced that the state will switch from a gross income eligibility test
to a net income eligibility test beginning July 1, 1999. The new income
formula will effectively raise the ceiling for the free program to 250%
FPL and the ceiling for the subsidized program to about 285% FPL.
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Puerto Rico
Approved
6/ 26/98
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Medicaid expansion to children through age 18 up to 200% of commonwealth
poverty level. (Commonwealth poverty level is $8,220 for a family of four.)
Children in public health system are included. More funds will be contributed
than the standard federal-state matching funds.
Status: Plan approved by HCFA on June 26, 98. (6/26/98)
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Rhode Island
Approved
5/8/98
Amendment Approved
2/5/99
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Medicaid expansion, RIte care, to children up to age 18 in families with
incomes up to 250% FPL. Priority to be given to children age 8-18. Additions
to plan: buy-in option available for pregnant women with incomes between
250% and 350% FPL, and children in families with incomes > 250% FPL.
6 mos continuous eligibility. Access restrictions based upon prior insurance
coverage within past year costing < $150/ mo/ individual or $300/ mo/
family.
Amendment expands RIte care coverage to 300% FPL. Will implement expansion
pending appropriation by legislature.
Status: Plan approved by HCFA May 8, 1998. Plan is second phase of expansion
previously approved by HCFA through Section 1115 Waiver Nov, 1993. Expansion
was effective May 1, 1997. (5/8/98)
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South Carolina
Approved
2/18/98
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Expansion of new program, Partners for Healthy Children Program, raising
coverage from 133% to 150% FPL and through age 18. Fee-for-service plan
and three managed care plans available.
Status: Plan approved by HCFA Feb 18, 1998. Began Oct. 1, 1997. (2/18/98)
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South Dakota
Approved 8/25/98
Amendment submitted
6/28/99
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Medicaid expansion for children age 6 through 18 in families with incomes
up to 133% FPL.
Status: Enrollment ongoing.
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Tennessee
Approved
9/3/99
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Original Plan:TennCare expansion to any uninsured child through age 18
in families with incomes up to 200% FPL. Technical amendment enabled TN
to participate in SCHIP. Plan includes elimination of deductibles and
reduction of copay from 8% to 2% of income. Children with parents who
have access to but cannot afford private insurance premiums are eligible.
Expansion approved by HCFA: Tennessee opted to use its CHIP allocation
to expand its Medicaid program to children born before Oct. 1, 1983, who
are under age 19 in families with incomes at or below 100 percent of the
federal poverty level and who could not have been enrolled under the operating
rules for the state's Medicaid demonstration program before April 1, 1997.
Status: Open enrollment for children without access to health insurance
will continue indefinitely. (1/7/98)
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Texas
Approved
Phase I
6/15/98
Submitted Phase II
6/25/99
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Phase I-Medicaid expansion accelerating eligibility for ages 15 through
18 up to 100% FPL.
Status: Enrollment ongoing.
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Phase II- Separate state program to cover children through age 18 up
to 200% FPL.
Status: Bill S 445 signed by Governor on 5/24/99.
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US Virgin Islands
Approved
10/23/98
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Medicaid expansion
to children receiving services through a territory-funded program. Current
medically needy annual income level for family of four is $8,500. The local
government will not expand eligibility limits.
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Utah
Approved
7/10/98
Amendment Submitted
1/28/99
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Childrens Health Insurance Program, subsidized insurance to children
through age 18 in families with incomes between 100% and 200% FPL. Benefits
package will be modeled after state employees health plan with added basic
dental and hearing services, mental health care, pediatric care as a minimum.
Copays required-families with incomes between 100% and 150% FPL pay slightly
lower copay than those between 150% and 200% FPL. No premiums and enrollment
fees required but copays required at all levels.
Status: Plan approved by HCFA on July 10, 1998. Bill H 137 authorizing
program enacted. Expected start date was July 1, 98. (7/13/98)
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Vermont
Submitted
3/17/98
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Medicaid expansion, Dr. Dynasaur, to increase coverage for children up
to age 18 from 225% ® 275% FPL. Will amend
Section 1115 waiver to cover up to 300% FPL and to cover parents of low-income
children up to 185% FPL with a limited Medicaid benefit package. Incomes
up to 275% FPL will receive full benefits and limited benefits to 275%
- 300% FPL.
Status: Plan submitted to HCFA on Mar 17, 1998. Bill authorizing expansion
passed House and is included in the FY 1999 budget. (3/19/98)
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Virginia
Approved
10/23/98
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VA Childrens Medical Security Insurance (part 2), a state program
administered by Dept of Medical Assistance Services (Medicaid agency)
will cover children through age 18 between 150% FPL and 185% FPL. Medicaid
benefits package and methodologies will be used. Premiums and copays will
be assessed.
Status: Governor's proposal. Gov vetoed original bill but signed budget
bill H 30 that contained authorizing information.
HB 2230 signed by Governor on 5/7/99. Expands CMCIP program to 200% FPL
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| Washington
Approved
9/8/99
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Establishes separate state program to cover children through age 18 up
to 250% FPL. Legislation also directs department to continue to seek a
technical fix to federal legislation, allowing Washington access to SCHIP
funds for outreach/covering children below 200% FPL.
Status: SB 5416 signed by Governor on 5/17/99. Implementation
proposed for January 2000.
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West Virginia
Approved
6/18/98
Amendment Phase II
Approved
3/19/99
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Phase I-Medicaid expansion increasing coverage to children from age 1
through 5 in families with incomes up to 150% FPL. Bureau of Medical Services
will administer both Medicaid expansion and the private program under
Title XXI.
Status: Bill H 4299 passed to authorize phase I and II. (7/13/98)
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Phase II-New insurance program for children ages 6 through 18 in families
with incomes up to 150% FPL. The benefit package will be modeled on the
state employees benefit packages. Care will be delivered in a fee-for-service
system. There will be no cost to families in the program. Bureau of Medical
Services will administer both the private program and Medicaid expansion
under Title XXI.
Status: Bill H 4299 passed to authorize phase I and II.
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Wisconsin
Approved Phase I
5/29/98
Approved Phas II
1/19/99
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Phase I-Under the name of BadgerCare, Medicaid expansion accelerating
coverage to children from age 14 through 18 up to 100% FPL.
Phase II - Expands BadgerCare to children through age 18 up to 185% FPL.
In conjunction with the approved 1115 waiver, Medicaid benefits under
BadgerCare are extended to parents of eligible children up to 185% FPL.
Families remain eligible until income exceeds 200% FPL. States will receive
Title XXI enhanced matching rate only for eligible children.
Status: Phase I implemented in May 1999. Phase II began July 1,
1999.
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Wyoming
Approved
9/8/99
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Medicaid look-alike
separate state program for children through age 18 up to 150% FPL. A separately
administered voucher program will also be implemented.
Status: Governor signed HB 100 on 3/1/99. Implementation
slated for July 2000. |