|
|
|
|
|
|
|
|
|
|
|
Medicaid and CHIP Eligibility Table by State
In This Article
Online Resources
|
Under the new federal health reform legislation, Medicaid will be expanded to all Americans with incomes up to 133 percent of federal poverty guidelines ($29,327 a year for a family of four in 2010) effective in 2014. This represents a significant change for state Medicaid programs, which will expand to cover additional people who do not currently qualify. The new law provides states with 100 percent federal financing for all those who are newly eligible for Medicaid for the first three years through 2016. The federal match decreases to 95 percent in 2017; 94 percent in 2018; 93 percent in 2019 and 90 percent for 2020 and beyond. Currently the states share the cost of the Medicaid program with the federal government. The federal government share, called the federal medical assistance percentage or FMAP, is calculated based on a three-year average of state per capita personal income compared to the national average. A state with average per capita personal income receives an FMAP of 55 percent; no state may receive less than 50 percent.
The Children's Health Insurance Program (CHIP), provides insurance for certain children who are ineligible for Medicaid but cannot afford private insurance. States receive a higher federal match to pay for CHIP coverage than for their Medicaid programs. This match can either be used to create a separate CHIP program or to create an expansion of the state's Medicaid program, which raises the Medicaid eligibility level for children.
Listed below are the Medicaid (M) and CHIP (C) eligibility levels for eligible populations in each state as of July 1, 2010.
|
State
|
Infants
% FPL
|
Children
1-5 % FPL
|
Children
6-19 % FPL
|
Pregnant
Women % FPL
|
Parents of
Medicaid
Eligible kids % FPL
|
Childless Adults % FPL
|
|
Federal Minimum level
|
133
|
133
|
100
|
133
|
N/A
|
N/A
|
|
Alabama
|
133 M
300 C
|
133 M
300 C
|
100 M
300 C
|
133
|
24
|
|
|
Alaska
|
175 M+
|
175 M+
|
175 M+
|
175
|
81
|
|
|
Arizona
|
140 M
200 C
|
133 M
200 C
|
100 M
200 C
|
150
|
106
|
110
|
|
Arkansas
|
200 M+
|
200 M+
|
200 M+
|
200
|
200#
|
200#
|
|
California
|
200 M
250 C
|
133 M
250 C
|
100 M
250 C
|
200
|
106
|
|
|
Colorado
|
133 M
205 C
|
133 M
205 C
|
100 M
205 C
|
200
|
66
|
|
|
Connecticut
|
185 M
300 C
|
185 M
300 C
|
185 M
300 C
|
250
|
300#
|
**
|
|
Delaware
|
200 M
|
133 M
200 C
|
100 M
200 C
|
200
|
121
|
110
|
|
Florida
|
200 M
|
133 M
200 C
|
100 M
200 C
|
185
|
53
|
|
|
Georgia
|
200 M
235 C
|
133 M
235 C
|
100 M
235 C
|
200
|
50
|
|
|
Hawaii
|
300 M+
|
300 M+
|
300 M+
|
185
|
200#
|
200# (closed)
|
|
Idaho
|
133 M
185 C
|
133 M
185 C
|
133 M
185 C
|
133
|
185#
|
185#
|
|
Illinois
|
200 M
|
133 M
200 C
|
133 M
200 C
|
200
|
185
|
|
|
Indiana
|
200 M
250 C
|
150 M
250 C
|
150 M
250 C
|
200
|
200#
|
200# (closed)
|
|
Iowa
|
300 M
|
133 M
300 C
|
133 M*
300 C
|
300
|
250#
|
250#
|
|
Kansas
|
150 M
241 C
|
133 M
241 C
|
100 M
241 C
|
150
|
32
|
|
|
Kentucky
|
185 M
200 C
|
150 M
200 C
|
150 M
200 C
|
185
|
62
|
|
|
Louisiana
|
200 M
250 C
|
200 M
250 C
|
200 M
250 C
|
200
|
25
|
|
|
Maine
|
200 M
|
150 M
200 C
|
150 M*
200 C
|
200
|
206
|
100# (closed)
|
|
Maryland
|
300 M+
|
300 M+
|
300 M+
|
250
|
116
|
116#
|
|
Massachusetts
|
200 M
300 C
|
150 M
300 C
|
150 M
300 C
|
200
|
133#
|
100#
|
|
Michigan
|
185 M
200 C
|
150 M
200 C
|
150 M
200 C
|
185
|
64
|
|
|
Minnesota
|
280 M+
|
275 M+
|
275 M+
|
275
|
275#
|
|
|
Mississippi
|
185 M
200 C
|
133 M
200 C
|
100 M
200 C
|
185
|
44
|
|
|
Missouri
|
185 M
300 C
|
150 M
300 C
|
150 M
300 C
|
185
|
25
|
|
|
Montana
|
133 M
250 C
|
133 M
250 C
|
133 M
250 C
|
150
|
56
|
|
|
Nebraska
|
200 M+
|
200 M+
|
200 M+
|
185
|
58
|
|
|
Nevada
|
133 M
200 C
|
133 M
200 C
|
100 M
200 C
|
185
|
200#
|
|
|
New Hampshire
|
300 M
|
185 M
300 C
|
185 M
300 C
|
185
|
49
|
|
|
New Jersey
|
200 M
250 C
|
133 M
250 C
|
133 M
250 C
|
200
|
200
|
|
|
New Mexico
|
235 M+
|
235 M+
|
235 M+
|
235
|
250#
|
250# (closed)
|
|
New York
|
200 M
400 C
|
133 M
400 C
|
100 M
400 C
|
200
|
150
|
100
|
|
North Carolina
|
200 M
|
200 M
|
100 M
200 C
|
185
|
49
|
|
|
North Dakota
|
133 M
160 C
|
133 M
160 C
|
100 M
160 C
|
133
|
59
|
|
|
Ohio
|
200 M+
|
200 M+
|
200 M+
|
200
|
90
|
|
|
Oklahoma
|
185 M+
|
185 M+
|
185 M+
|
185
|
200#
|
213#
|
|
Oregon
|
133 M
300 C
|
133 M
300 C
|
100 M
300 C
|
185
|
185#
|
185#
|
|
Pennsylvania
|
185 M
300 C
|
133 M
300 C
|
100 M
300 C
|
185
|
34
|
|
|
Rhode Island
|
250 M+
|
250 M+
|
250 M+
|
250
|
181
|
|
|
South Carolina
|
185 M
200 C
|
150 M
200 C
|
150 M
200 C
|
185
|
89
|
|
|
South Dakota
|
140 M
200 C
|
140 M
200 C
|
140 M
200 C
|
133
|
52
|
|
|
Tennessee
|
185 M
250 C
|
133 M
250 C
|
100 M
250 C
|
250
|
$55,000/year#
|
$55,000/year#
|
|
Texas
|
185 M
200 C
|
133 M
200 C
|
100 M
200 C
|
185
|
26
|
|
|
Utah
|
133 M
200 C
|
133 M
200 C
|
100 M
200 C
|
133
|
44
150#
|
150#
|
|
Vermont
|
225 M
300 C
|
225 M
300 C
|
225 M
300 C
|
200
|
191~#
|
160~#
|
|
Virginia
|
133 M
200 C
|
133 M
200 C
|
133 M
200 C
|
200
|
29
|
|
|
Washington
|
200 M
300 C
|
200 M
300 C
|
200 M
300 C
|
185
|
74
|
|
|
West Virginia
|
150 M
250 C
|
133 M
250 C
|
100 M
250 C
|
150
|
33
|
|
|
Wisconsin
|
300 M+
|
300 M+
|
300 M+
|
300
|
200#
|
200#^ (closed)
|
|
Wyoming
|
133 M
200 C
|
133 M
200 C
|
133 M
200 C
|
100
|
52
|
|
|
District of Columbia
|
300 M+
|
300 M+
|
300 M+
|
300
|
207
|
211#**
|
** These states are rolling elgible individuals from a state-only funded program into the early Medicaid expansion option offered through the Affordable Care Act, more information to come.
# Waiver program, limited coverage program, and/or premium assistance program.
M Medicaid offers coverage to children up to this percentage of the federal poverty guidelines.
M+ State's Medicaid program has a CHIP expansion.
C State has a separate CHIP program offers coverage to children up to this percent of the federal poverty guidelines.
* Children up to age 21 are eligible.
~ The state also has a premium subsidy plan, called Catamount Health that is offered to parents and childless adults up to 300 percent of the federal poverty guidelines.
^ Wisconsin offers a more limited coverage plan called the BadgerCare Plus Core Plan for Childless Adults which is currently at maximum capacity and is closed for enrollment. The governor has a 2010 bill to allow those on this waiting list to fully purchase the coverage.
Federal Standards for Medicaid
Categorically eligible populations:
- Pregnant women up to 133 percent of federal poverty guidelines.
- Infants under age one are covered if their mother is on Medicaid at the time of birth or up to 133 percent of federal poverty guidelines; children ages 1 through 5 are covered up to 133 percent; and children ages 6 through 18 are covered up to 100 percent.
- Parent/guardian below Aid to Families with Dependent Children (AFDC) levels in 1996. There is no federal standard for income eligibility for this group. (National average of approximately 40 percent of federal poverty guidelines).
- People who receive Supplemental Security Income (SSI) due to a disability.
- Children who are adopted or in foster care are covered.
- Low-income recipients of Medicare are eligible. Once enrolled these people are known as "dual-eligible" enrollees.
Federal Matching Funds
In addition to these mandatory coverage categories of people, several optional populations can be covered with federal matching funds:
- Infants and pregnant women up to 185 percent of federal poverty guidelines.
- Parents of eligible children.
- Medicare recipients at higher income levels than required.
- Those who have high medical expenses relative to their income.
- Those with disabilities but who would lose eligibility based on income.
- Low-income, uninsured women diagnosed with breast or cervical cancer by the National Breast and Cervical Cancer Early Detection Program can be covered for cancer-related treatment.
- Through the Children's Health Insurance Program (CHIP), children can be covered, through Medicaid, up to 200 percent of federal poverty guidelines.
|
|
|
|
|
|
|
|
|
|
|
Issues & Resources
Find the NCSLstaff member who handles the issue in which you are interested.
NCSLprovides access to current state and federal legislation and a comprehensive list of state documents, including state statutes, constitutions, legislative audits and research reports.
Members
As legislators and legislative staff, you are part of the nation's largest, most influential and only bipartisan organization of state legislators and staff.Learn about the resources NCSL has for you.
NCSL offers an array of services for legislative staff. Find out what's available.
|
|
|
|
|
|
|
|
|
|
| ©2013 National Conference of State Legislatures. All Rights Reserved. |
|
|
|