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State |
Enacted State Initiatives |
| Alaska |
In 2007, SB 27 (Chapter 48) was enacted, which increases Medicaid/SCHIP eligibility for children from 150 percent of the federal poverty level to 175 percent of the federal poverty level. |
| Arizona | In 2007, HB 2789 (the fiscal year 2007-2008 state budget) was enacted which removes the rule that prohibited schools from participating in outreach efforts and clarifies that school districts may distribute information about the Arizona Health Care Cost Containment System to potentially eligible students and their families. For more information about Arizona's SCHIP program: Arizona KidsCare |
| California |
In 2004, CMS approved a pilot program to increase eligibility in four California counties through the County Children's Health Insurance Program (C-CHIP). Children, ages 19 and younger, whose family income is up to 300 percent federal poverty level are covered in three counties (Alameda, San Francisco, San Mateo, and Santa Clara) using federal matching dollars. Alameda county has not implemented the program. San Mateo covers children from 300 to 400 percent federal poverty level using county funds. |
| Colorado | In 2007, Colo. Sess. Laws, Chap. 347 (SB 211) was enacted which declares the state's aim to provide coverage to all low-income children by 2010. The law implements presumptive eligibility and allows for 12-month continuous eligibility for children. In 2008, SB 160 was enacted which increases SCHIP eligibility from 205 percent of the federal poverty guidelines to 225 percent of the federal poverty guidelines. The law allows that if funding is available, the eligibility level can be raised to 250 percent of the federal poverty guidelines. |
| Connecticut | Public Act No. 07-185 (2007 SB 1484) increased the HUSKY (SCHIP) program eligibility level from 300 percent federal poverty level to 400 percent federal poverty level and calls for the automatic enrollment of all eligible newborns into the HUSKY program. Families with incomes above 400 percent federal poverty level may buy-in to the HUSKY program at full cost. For more information about Connecticut's SCHIP program: Connecticut HUSKY |
| District of Columbia | In January 2007, the DC City Council approved the Fiscal Year 2007 Budget Support Act of 2006 that expands Medicaid/SCHIP eligibility to 300 percent federal poverty level. The expansion was implemented in June 2007. For more information about the District of Columbia's SCHIP program: DC Healthy Families Insurance Program |
| Hawaii | Hawaii Rev. Stat. § 346-59.4 (2007 HB 1008) establishes a three year pilot program, Keiki Care, in which the state pays half the health insurance premiums (a mutual benefit society pays the other half and manages the administration) for children under the age of 19 who are uninsured (for any reason, including immigration status) and are ineligible for public insurance. Keiki Care is expected to cover as many as 3,500 children. The law also expands Hawaii's SCHIP program, QUEST, to cover children in families with incomes below 300 percent federal poverty level. For more information about Hawaii's SCHIP program: Hawaii QUEST; Keiki Care; Covering Kids |
| Illinois | HB 806 was enacted in 2005 and created the All Kids program. The All Kids program provides children up to the age of 18 with comprehensive health insurance which covers preventative care, dental and vision services, hospital costs, and prescription drugs, among other services. The program is available to all Illinois children without private health insurance and has no family income cap. Children do not need to be U.S. citizens for their parents to buy into the program. The children must not be eligible for state programs like Medicaid or Illinois CHIP. Premiums are based on a sliding income scale, starting at $40 per month per child. The All Kids program became effective July 1, 2006. For more information about Illinois' program: Illinois All Kids; More NCSL information |
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Indiana |
In May 2007, HB 1678 was enacted to increase SCHIP eligibility for children in families with incomes up to 300 percent federal poverty level. In May 2008, CMS approved the expansion of eligibility to only 250 percent federal poverty level. It is expected that this expansion will allow an additional 5,000 children to enroll in the program in the first year, and up to 10,000 children in subsequent years. |
| Iowa |
In 2007, HF 909 was enacted which allocates new state funds to increase outreach to children eligible to be enrolled in SCHIP. In 2008, HF 2539 was enacted which provides an additional $25 million over the next three years to extend coverage to more than 50,000 children. The law increases SCHIP eligibility from 200 percent of the federal poverty guidelines to 300 percent of the federal poverty guidelines. The law establishes cost sharing requirements for families with incomes between 200 and 300 percent of the federal poverty guidelines. The expansion is expected to be effective as of July 1, 2009. The law also provides provisions to improve outreach to eligible children. Beginning with the 2008 tax return forms, parents can identify any dependent children who do not have health care coverage. If their income on the tax return meets the income eligibility requirements for any medical assistance program, including hawk-i, information about enrollment will be sent to them. |
| Kansas | In 2008, SB 81 was enacted which, subject to appropriations, increases SCHIP eligibility from 200 percent of the federal poverty level to 225 percent of the federal poverty guidelines in 2009 and, finally, to 250 percent of the federal poverty guidelines in 2010. The law establishes cost sharing provisions on a sliding scale basis. New participants would not be eligible for coverage for at least eight months if they previously had comprehensive health benefit coverage, with some exceptions. This law also requires participants in SCHIP to present documentary evidence of citizenship or of being a lawful alien to be eligible. The law amends the current SCHIP program to allow contributions to health insurance premiums in SCHIP to be made to a health savings account. In addition, payments for health insurance premiums can be made in conjunction with an employer sponsored health insurance premium assistance plan. For more information about Kansas's SCHIP program: Kansas Health Wave |
| Louisiana |
In the 2007 legislative session, Louisiana passed HB 542 (Act 407) which created the Louisiana Children and Youth Health Insurance Program, expanding Louisiana's SCHIP program, LaCHIP. Act 407 aims to expand eligibility to children in families with incomes up to 300 percent federal poverty level from the former eligibility threshold of 200 percent federal poverty level. A request for approval of the plan was submitted to CMS in September 2007. In February 2008, CMS approved the expansion of eligibility to only 250 percent federal poverty level. This expansion will extend coverage to approximately 6,500 additional families, adding to the 115,271 children enrolled in LaCHIP. The coverage under this expansion will be provided through the State Group Benefits program, which also provides insurance to state government employees. Families will contribute premiums (approximately $50), co-payments and deductibles. |
| Maryland | HB 1391 encourages eligible parents to enroll their children in the Maryland Children's Health Program (MCHP), Maryland's SCHIP program. The Kids First Act requires the comptroller to send a notice this summer (2008) regarding eligibility for MCHP to families with incomes up to 300 percent federal poverty level based on state tax return information. The act also requires parents to report on their next income tax return, the presence or absence of health care coverage for each dependent child. The act leaves open the possibility of a mandate for enrollment if more than 3 percent of children remain uninsured by 2010. At that time the state would decide on whether to withhold the child tax exemption from parents whose children are eligible but not enrolled in MCHP. The act also calls for a study of ways to make health insurance affordable for children whose parents' incomes are higher than the state program's eligibility requirements, but too low to afford private insurance coverage. This legislation has been passed by the legislature and is awaiting action by the governor. For more information about Maryland's SCHIP program: Maryland Children's Health Program (MCHP) |
| Massachusetts | In April of 2006, Massachusetts passed comprehensive health care reform called the "Act Providing Access to Affordable, Quality, Accountable Health Care." The law does not specifically address children, but it does have components that will increase access for them. The law includes a Medicaid expansion from the previous level of 200 percent of federal poverty guidelines to 300 percent of the federal poverty level. The Commonwealth Insurance Plan will provide low-cost, state subsidized (for specified income levels) insurance that is portable from job to job; presumably, children will gain access to insurance through these programs. The individual mandate that all state residents have health insurance applies only to people over the age of 18. The 2006 HB 4847 was enacted in May 2006 (Chapter 58). For more information about Massachusetts' program: MassHealth |
| Minnesota | In 2007, Chapter 147 (HF 1078) was enacted which allocates funds to increase outreach to individuals eligible for public health coverage programs. The law calls for implementation of a statewide public awareness and education campaign on the importance and availability of health coverage. The law also includes measures to simplify application and renewal policies. For more information about Minnesota's SCHIP program: Minnesota CHIP |
| Montana |
In 2007, SB 22 was enacted to increase the SCHIP eligibility level for children in families with income up to 175 percent of federal poverty guidelines--from the current level of 150 percent--provided there is funding available. The bill requires the state to leverage any federal dollars available to fund the program, possibly through a Medicaid waiver. |
| New Hampshire | SB 192, enacted in 2007, creates an outreach program in SCHIP. The purpose of the outreach program will be to increase enrollment by informing new parents of the program's availability and assisting families in the completion of the application process as necessary. In addition, funds will be allocated for the development of a volunteer program, with tasks including promoting the program to eligible families and identifying families who may require assistance with the application process. Agencies that provide additional follow-up with applicants will be reimbursed with an enhanced application fee for outreach assistance. For more information about New Hampshire's SCHIP program: New Hampshire Healthy Kids |
| New Jersey | In 2005, New Jersey enacted SB 2236 creating a new program within SCHIP, FamilyCare Advantage, that allows families whose income is above 350 percent of the federal poverty level to buy into SCHIP coverage for their uninsured children. Families are responsible for paying the full premiums, but rates are lower than the average private insurance plan ($137/month for one child to $411/month for 3 or more children). This buy-in program does not rely on any federal funding. The state reached an agreement with the insurance provider, Horizon Blue Cross Blue Shield of New Jersey, in December 2007 and implementation of the FamilyCare Advantage program began in January 2008. The program expects to extend coverage to 15,000 children. This legislation included other reforms to New Jersey's SCHIP program, FamilyCare, such as streamlining the application process and reversing the governor's freeze on covering parents through FamilyCare. In 1999, New Jersey expanded SCHIP eligibility from 200 percent of the federal poverty level to 350 percent of the federal poverty level. Currently, children in families with incomes between 150 percent federal poverty level and 350 percent federal poverty level are required to pay monthly premiums and co-payments based on a sliding scale by income. For more information: New Jersey FamilyCare |
| New Mexico | In 2006, SB 267 was enacted to create the Premium Assistance for Kids (PAK) program for uninsured children up to age 11 who are ineligible for Medicaid or SCHIP. Through this state-funded program, the state pays up to 50 percent of the premiums for participating plans. In addition, the state expanded Medicaid eligibility for children under six by increasing allowable earning and childcare disregards. For more information about New Mexico's SCHIP program: New Mexico New MexiKids |
| New York | The state legislature approved the state budget for 2008 (SB 2108; 2007 N.Y. Laws, Chap. 58), which includes an SCHIP eligibility level increase from 250 percent of the federal poverty level up to 400 percent of the federal poverty level. Families with incomes above 400 percent may buy-in to the program for their children.
New York's existing program was enacted in 1990; the Medicaid or Child Health Plus program (New York's SCHIP) covers residents under the age of 19 in families with incomes up to 160 percent of federal poverty guidelines at no cost. For families with incomes at 161-250 percent of federal poverty guidelines, they may enroll with cost-sharing restrictions. Above 250 percent federal poverty level, children may enroll at full cost. Illegal immigrants may participate in the program, but the state uses no federal dollars to fund their care. |
| North Dakota | In 2007, HB 1463 was enacted which increased SCHIP eligibility levels from the current level of 140 percent of federal poverty guidelines to 150 percent for children up to age 19. For more information about North Dakota's SCHIP program: North Dakota CHIP |
| North Carolina | In 2007, North Carolina enacted HB 1473 which created the North Carolina Kids' Care that will increase SCHIP eligibility for kids whose family income is between 200 percent federal poverty level and 300 percent federal poverty level. The law states that the expansion will become effective July 1, 2008. Due to the August 2007 CMS directive, North Carolina is exploring funding options for the expansion. For more information about North Carolina's SCHIP program: North Carolina Health Choice for Children |
| Ohio | In June 2007, the 2008-09 state budget (HB 119), was signed into law, which includes an expansion of SCHIP eligibility for children with family incomes up to 300 percent of the federal poverty level from the current level of 200% of the federal poverty level. In response to the August 2007 CMS directive, Ohio explored additional funding options. In April 2008, an executive order was signed by the governor establishing the Children's Buy-In program, which enables families with incomes above 300 percent federal poverty level to purchase public coverage for their children. The program will accept applications starting April 1, 2008 and begin enrollment June 1, 2008. For more information about Ohio's SCHIP program: Ohio Healthy Start |
| Oklahoma | SB 424, the All Kids Act, was enacted in 2007 which creates a premium assistance program within Medicaid for children under age 18 whose family income is between 185 percent and 300 percent of the federal poverty level. The program is expected to assist as many as 42,000 additional children in obtaining health care coverage. As a result of the August 2007 CMS directive, Oklahoma will only provide this premium assistance program to children whose family income is up to 250 percent of the federal poverty level. For more information about Oklahoma's SCHIP program: Oklahoma SOONERCARE |
| Pennsylvania | In 2006, SB 1192 was enacted to create the Cover All Kids program, which expands eligibility for the SCHIP program. Prior to the expansion, Pennsylvania covered children in families with income up to 200 percent of federal poverty guidelines through CHIP. The state will continue that coverage and open the program to children in families with income up to 300 percent of federal poverty guidelines with premiums based on a sliding income scale, ranging from $36 to $57 per child per month. Families with incomes above this threshold may buy into the CHIP program if coverage has been denied due to a preexisting condition, private insurance premiums are 150 percent higher than the state's monthly premium, or the cost of insurance exceeds 10 percent of annual family income. For parents at this income level who can access private insurance but cannot afford the premiums, the state will subsidize the cost. The program became effective on November 2, 2006. For more information about Pennsylvania's SCHIP program: Pennsylvania CHIP |
| South Carolina | A provision in the 2007-2008 budget (2007 HB 3620) passed the state legislature in June 2007 and creates a separate State Children’s Health Insurance Program that expands eligibility to children with family incomes up to 200 percent of the federal poverty level. This provision was vetoed by the Governor, but the legislature overrode the veto. For more information about South Carolina's SCHIP program: South Carolina Partners for Healthy Children |
| Tennessee |
Cover Kids (2006 Tenn. Pub. Acts, Chap. 867) was enacted in 2006. The state received federal approval in January 2007 and the program began implementation in April 2007. The Cover Kids plan expands health insurance to uninsured children under age 19 who are not eligible for Medicaid and who have been uninsured for at least three months. Cost-sharing for more services is required for all participants. Eligible enrollees with income less than 250 percent of federal poverty guidelines do not pay premiums. Families whose income is above 250 percent federal poverty level can buy-in to the program by paying monthly premiums (approximately $225 per month per child for the year 2008). The benefits of the plan are based on the state employees' health insurance plan and focus on preventative and well-child care. |
| Texas | In June 2007, HB 109 was enacted which created a community outreach campaign for SCHIP and extended continuous coverage for children from 6 to 12 months and eliminated a 90-day waiting period, except for certain applicants. For more information about Texas's SCHIP program: Texas CHIP |
| Utah | The Governor pledged $4 million to lift the enrollment cap on the state's SCHIP program to enroll 14,000 additional children in his 2007 State of the State address. Funding was approved in the 2007 state budget, and enrollment was re-opened in July 2007. In May 2008, HB 326 was enacted with requires the Department of Health to keep enrollment in Utah's CHIP open so that all eligible children who apply for coverage under CHIP can enroll in the program and designates appropriations. For more information about Utah's CHIP program: Utah CHIP |
| Vermont |
Enacted in 2006, HB 861 (Act 191) aimed to achieve near-universal coverage for state residents. Before this legislation, eligibility levels for children for Medicaid/SCHIP programs were already at 300 percent of federal poverty guidelines. However, the reforms reduce premiums for children in the Dr. Dynasaur, Vermont's SCHIP program, by half. A private insurance plan that is subsidized by the state (for individuals or families with income below 300 percent of federal poverty guidelines) will be available for children and families who are not eligible for other public insurance. Individuals and families with income above 300 percent of federal poverty guidelines may buy-in to the program. In addition, the reforms provided funding for outreach efforts. |
| Washington | SB 5093, enacted in 2007 (Chapter 5), expands Washington's CHIP eligibility level to children, regardless of their citizenship status, in families with incomes at or below 250 percent of federal poverty guidelines. Cost sharing on a sliding scale is required for families with incomes between 200 and 250 percent of federal poverty guidelines. The law includes outreach and administrative measures, including consolidating applications for three state-sponsored insurance programs into one application. For more information about Washington's SCHIP program: Washington SCHIP |
| West Virginia | In 2006, HB 4021 (Chapter 106) was enacted which expanded SCHIP eligibility up to 300 percent of the federal poverty level. In January 2007, the state began enrolling children with incomes up to 220 percent of the federal poverty level. Due to the August 2007 CMS directive, the expansion to 300 percent of the federal poverty level has been delayed. For more information about West Virginia's SCHIP program: West Virginia WVSCHIP |
| Wisconsin |
In 2007, SB 40 (Act 20) was enacted to expand SCHIP eligibility to families with incomes up to 300 percent of the federal poverty level. Due to the August 2007 CMS directive, state-only funds will be used to finance coverage for children with family incomes between 250 and 300 percent of the federal poverty level. Under the BadgerCare Plus program, Wisconsin's SCHIP program, families with annual incomes between 200 percent and 300 percent of the federal poverty level are eligible for health coverage for their children and will be required to pay premiums (approximately $10 to $90.74 per month). Families with annual incomes more than 300 percent of the poverty level may buy-in to the program and must contribute the full cost of coverage, about $1,089 per child per year. The program does not cover undocumented immigrant children or parents whose employers cover 80% of the cost of family coverage. |
Source: National Conference of State Legislatures, Kaiser Family Foundation: State Coverage Initiatives for Children
Note: List may not be comprehensive, but is representative of state plans and proposals. NCSL appreciates additions and corrections. To submit additions or corrections, please email us at health-info@ncsl.org
State Children's Health Insurance Programs (SCHIP)
National Conference of State Legislatures
Frequently Asked Questions on SCHIP
National Conference of State Legislatures
Legal Review of the CMS "Crowd-Out" Clarification Letter August 17, 2007
National Conference of State Legislatures
ABCs of The State Children's Health Insurance Program (SCHIP)
National Conference of State Legislatures, 2007
Highlights FY 2009 Administration Budget Request Selected Health Programs-IN BRIEF
National Conference of State Legislatures
FY 2009 Federal Budget - Legislative and Regulatory Proposal: Medicaid, SCHIP, and Medicare
National Conference of State Legislatures
Understanding the Uninsured: Tailoring Policy Solutions for Different Subpopulations
National Institute for Health Care Management (NIHCM), April 2008
SCHIP State Plan Amendments Currently Under Review by CMS
Map shows SCHIP programs by type (stand-alone program, Medicaid expansion, combination program) and a summary of state amendments under review.
Centers for Medicare and Medicaid Services, August 2007.
Moving Backward: Status Report on the Impact of the August 17 SCHIP Directive to Impose New Limits on States' Ability to Cover Uninsured Children
Center for Children and Families, Georgetown University Health Policy Institute, December 2007
At Least Nine of 17 States with SCHIP Income Eligibility Thresholds Above 250% of Federal Poverty Level Will Meet Federal Enrollment Guidelines for Expanding Coverage, CMS Says
Kaiser Family Foundation, Daily Health Policy Report, April 10, 2008
Congressional Budget Office testimony from the hearing is available online.
Reports from the Kaiser Family Foundation's Commission on Medicaid and Uninsured (KCMU)
The latest studies indicate that children's health insurance coverage increased in 2007, but these Kaiser reports state that a declining economy coupled with federal inaction on SCHIP reauthorization and new CMS rules are compromising efforts to reduce the number of uninsured.
The Kaiser Commission on Medicaid and the Uninsured, Kaiser Family Foundation, January 2008.
- Dependent Status: Insurance Coverage for Young Adults
- Medicaid
- Access to Health Care and the Uninsured
- State Health Reform Legislation
- Children, Adolescent, and Women's Health Policy Topics
SCHIP Main Page || NCSL-SCHIP Resources || Other SCHIP Resources
Children, Adolescent and Women's Health Policy Topic List
This site is made possible by project MCU 1 H03 MC 00017, from the Maternal and Child Health Bureau (Title V, Social Security Act), Health Resources and Services Administration, U.S. Department of Health and Human Services.
A Snapshot of States Affected by the August 17th 2007 CMS Directive
| States with enacted effective coverage levels above 250 percent of the federal poverty level | States that covered children above 250 percent of the federal poverty level before the directive and will need to comply by August 2008 | States that have curtailed children's coverage expansions due to the directive | States that have implemented children's coverage expansions using state funds due to the directive | States with coverage expansions scheduled to be implemented in 2008 |
| CA |
X |
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| CT |
X |
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| DC |
X |
|||
| HI |
X |
|
||
| IL |
X |
|||
| IN |
X |
|||
| LA |
X |
|||
| MD |
X |
|||
| MA |
X |
|||
| MN |
X |
|||
| MO |
X |
|||
| NH |
X |
|||
| NJ |
X |
|||
| NY |
X |
|||
| NH |
X |
|||
| OH |
X |
X | ||
| OK |
X |
|||
| PA |
X |
|||
| RI |
X |
|||
| VT |
X |
|||
| WA |
X |
X | ||
| WV |
X | |||
| WI |
X |
Source: National Conference of State Legislatures and the Center for Children and Families, Georgetown University Health Policy Institute, December 2007
2008 Federal Poverty Guidelines
Source: Department of Health and Human Services (HHS), 2008. For more information: click here
Guidelines for the 48 Contiguous States and the District of Columbia
| People in Family Unit | Poverty Guidelines |
| 1 | $10,400 |
| 2 | $14,000 |
| 3 | $17,600 |
| 4 | $21,200 |
| 5 | $24,800 |
| 6 | $28,400 |
| 7 | $32,000 |
| 8 | $35,600 |
| More than 8 | Add $3,600 for each additional person |
Guidelines for Alaska
| People in Family Unit | Poverty Guidelines |
| 1 | $13,000 |
| 2 | $17,500 |
| 3 | $22,000 |
| 4 | $26,500 |
| 5 | $31,000 |
| 6 | $35,500 |
| 7 | $40,000 |
| 8 | $44,500 |
| More than 8 | Add $4,500 for each additional person |
Guidelines for Hawaii
People in Family Unit
Poverty Guidelines
1
$11,960
2
$16,100
3
$20,240
4
$24,380
5
$28,520
6
$32,660
7
$36,800
8
$40,940
More than 8
Add $4,140 for each additional person
SCHIP Main Page || NCSL-SCHIP Resources || Other SCHIP Resources
© 2008 National Conference of State Legislatures, All Rights Reserved
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