States Moving Forward: Child Health Coverage
The following states have implemented initiatives or enacted legislation to provide health coverage to uninsured children during 2006 and 2007. For information on eligibility levels and program elements, by state, see Facts and Statistics.
Alaska |
Expanded SCHIP-financed Medicaid coverage to children with family income from 154% to 175% of the 2007 federal poverty level (FPL). 1 |
Implemented in July 2007. |
Arizona |
Increased funding for outreach to more aggressively enroll eligible children in Medicaid and KidsCare (Arizona's SCHIP program) through contracts with community-based organizations and schools. 2 |
Funding approved in Arizona's 2007 state budget. Contracts with seven community-based organizations went into effect January 2008. |
Colorado |
Enacted legislation that: provides presumptive eligibility for children in Medicaid and SCHIP; expands SCHIP eligibility for children and pregnant women with family income from 200% to 205% of the FPL; and establishes a goal of covering all low-income children by 2010. Legislation also was adopted to increase the number of children enrolled in Medicaid and SCHIP with a medical home. 3 |
Legislation enacted in 2007. Implemented expansion and presumptive eligibility January 2008 while implementation of other initiatives is ongoing. |
Connecticut |
Implemented presumptive eligibility for newborns in Medicaid and waived the first four months of premiums for newborns in SCHIP. Also allocated $1 million to fund outreach contracts with schools and community-based organizations to find and enroll eligible children. 4 |
Presumptive eligibility and premium waiver program implemented in 2007. Funding for outreach allocated in Connecticut's 2007 state budget. |
District of Columbia |
Expanded SCHIP-financed Medicaid coverage to children with family income from 200% to 300% of the FPL. 5 |
Implemented in July 2007. |
Florida |
Implemented a new outreach initiative, co-led by Governor Charlie Crist (R) and Alex Sink (D), the new Chair of the Healthy Kids Corporation, to enroll more uninsured children eligible for Medicaid and SCHIP. 6 |
Implemented in July 2007. |
Hawaii |
Expanded SCHIP-financed Medicaid coverage to children with family income from 200% to 300% of the FPL. Eliminated premiums for all children (previously required premiums for children with family income between 251% and 300% of the FPL). Established 3-year pilot program (Keiki Care) to provide free health care for children not eligible for Medicaid/SCHIP. 7 |
Expansion implemented in October 2006. Premiums eliminated in February 2008. Pilot program enrollment began March 2008 (coverage to start April 1, 2008). |
Illinois |
Created All Kids (a combination of Medicaid, SCHIP and state-only funded programs) to provide health coverage to all children, regardless of income, health status or immigration status. 8 |
Implemented in July 2006. As of December 2007, 200,000 children have enrolled in All Kids (140,000 who were previously eligible). 9 |
Indiana |
Expanded SCHIP eligibility for children with family income from 200% to 300% of the FPL. 10 |
Expansion enacted in 2007. Due to directive, Indiana plans to cover children only to 250% of the FPL. 11 |
Iowa |
Increased tobacco tax by $1 million to fund coverage for 10,500 more uninsured, eligible children. 12 |
Outreach activities to enroll these children set to begin in early 2008. |
Louisiana |
Created a separate SCHIP program, called the Louisiana Children and Youth Health Insurance Program, for children with family income between 200% and 300% of the FPL. 13 |
Expansion enacted in 2007. Due to the directive, Louisiana's State Plan Amendment was approved by CMS with restrictions. CMS approved an expansion up to 250% of the FPL gross income (the state had intended to use the same deductions as their Medicaid and SCHIP programs) with a 12-month waiting period. Approval was received on February 27, 2008. 14 |
Massachusetts |
As part of a broader universal coverage initiative, expanded MassHealth (the state's Medicaid and SCHIP programs) eligibility for children with family income from 200% to 400% of the FPL. Also expanded coverage for children ineligible for MassHealth through the state's Children's Medical Security Plan. 15 |
Implemented in July 2006. As of February 2008, 40,000 more children have been enrolled (22,000 who were previously eligible). 16 |
Minnesota |
Allocated funding for outreach and a number of administrative simplification policies that are expected to result in 30,000 more children enrolling in the state's Medicaid and SCHIP programs. Simplifications include lower premiums, a shorter children's-only application and a 12-month renewal period (an increase from 6 months). 17 |
Legislation enacted in 2007, implementation planned for 2008. |
Montana |
Expanded SCHIP eligibility for children with family income from 150% to 175% of the FPL. 18 |
Implemented in July 2007. |
New Hampshire |
Allocated funding to cover an additional 10,000 uninsured children eligible for Healthy Kids (the state's Medicaid and SCHIP programs). 19 |
Funding approved in New Hampshire's 2007 state budget. |
New York |
Expanded SCHIP eligibility for children with family income from 250% to 400% of the FPL. Also enacted policies and funding to simplify the Medicaid and SCHIP application and renewal processes including administrative income verification, allowing presumptive eligibility and increasing outreach to eligible children. 20 |
Implemented simplification and outreach measures in 2007 and early 2008. Due to directive, CMS denied the New York's application to expand eligibility up to 400% of the FPL. New York has since joined other states in a lawsuit challenging the directive. 21 |
North Carolina |
Created North Carolina Kids' Care providing subsidized insurance, either through Medicaid or SCHIP, to be determined, for children with family income between 200% and 300% of the FPL. 22 |
Expansion enacted in 2007. Due to directive and funding issues, North Carolina is currently exploring its options for expansion. 23 |
North Dakota |
Expanded SCHIP eligibility for children with family income from 140% to 150% of the FPL. 24 |
Expansion enacted in 2007. North Dakota has not yet submitted a State Plan Amendment to CMS for the expansion. 25 |
Ohio |
Expanded Medicaid and SCHIP eligibility for children with family income from 200% to 300% of the FPL and created a buy-in program for children with family income between 300% and 500% of the FPL. Also extended Medicaid eligibility for youth leaving the foster care system from 19 to 21. 26 |
Expansions enacted in 2007. Foster youth expansion implemented January 1, 2008. Due to the directive, Ohio is seeking federal matching funds for coverage to 250% of the FPL and is exploring options for covering children between 250% and 300% of the FPL. 27 |
Oklahoma |
Created premium assistance program for children with family income from 185% to 300% of the FPL. 28 |
Expansion enacted in 2007. Due to directive, Oklahoma plans to only provide premium assistance to children with family income up to 250% of the FPL through a 1115 waiver. 29 |
Pennsylvania |
Expanded SCHIP eligibility for children with family income from 200% to 300% of the FPL, with the option for families above that income level to buy into SCHIP if they have difficulty accessing or affording private coverage. 30 |
Implemented expansion in February 2007. As of March 7, 2008, 16,059 more children have enrolled (9,186 who were previously eligible). 31 |
South Carolina |
Expanded SCHIP eligibility for children with family income from 150% to 200% of the FPL. 32 |
Expansion enacted in 2007. Implementation is set for Spring 2008. |
Tennessee |
Created a separate SCHIP program, called Cover Kids, for children with family income up to 250% of the FPL and a buy-in program for children with family income above 250% of the FPL. 33 |
Implemented in March 2007. As of November 13, 2007, 15,000 more children have enrolled. 34 |
Texas |
Streamlined SCHIP enrollment and renewal processes, increased the asset test limit (SCHIP asset test applies only to families with income above 150% of the FPL), eliminated a 90-day delay in coverage, and allowed families to deduct some childcare expenses in calculating income. 35 |
Changes enacted in 2007 with many implemented September 1, 2007. Combined with other simplifications, these changes resulted in 48,000 more children enrolling. 36 |
Utah |
Allocated $4 million to leverage more federal SCHIP dollars for coverage. 37 |
Funded approved in Utah's 2007 state budget. As a result of new funding, SCHIP enrollment was re-opened on July 2, 2007. 38 |
Vermont |
Enacted universal coverage through Catamount Health Program, which included outreach funding and lower premium requirements for children covered through Dr. Dynasaur, the state's Medicaid/SCHIP program. 39 |
Implemented in 2006. |
Washington |
Expanded eligibility through Medicaid, SCHIP and a state-only program to cover children with family income up to 300% of the FPL, regardless of immigration status. Also created a buy-in program for children with family income above 300% of the FPL and increased funding for outreach and simplification measures. 40 |
Expansion and outreach enacted in 2007. First phase of implementation, the expansion up to 250% of the FPL, outreach and most simplifications, were implemented in July 2007. Second phase of implementation, up to 300% of the FPL and buy-in, is scheduled for January 2009. |
West Virginia |
Expanded SCHIP eligibility for children with family income from 200% to 300% of the FPL. 41 |
Expansion enacted in 2006. The expansion is being implemented in phases. The first phase to increase eligibility to 220% of the FPL, was implemented in January 2007. |
Wisconsin |
Created BadgerCarePlus to expand coverage for children with family income from 185% to 300% of the FPL. Also created a buy-in program for children with family income above 300% of the FPL, increased funding for outreach and lowered the cost of premiums for some families. 42 |
Expansions and outreach enacted in 2007. Implementation on February 1, 2008. Due to the directive, Wisconsin is using federal matching dollars to cover children with family income up to 250% of the FPL and state-only funds for children with family income between 250% and 300% of the FPL. 43 |
Footnotes
1. S.B. 27, 25th Legislature (Alaska, 2007). Back
2. Communication with Kim Van Pelt, Children's Action Alliance (March 21, 2007, April 3, 2007 and April 19, 2007); J. Erikson, "US Senate, state seeking more health care for kids," Arizona Daily Star (March 14, 2007); and H.B. 2789, 48th Legislature (Arizona, 2007). Back
3. S.B. 211, 66th General Assembly (Colorado, 2007); and S.B. 130, 66th General Assembly (Colorado, 2007). Back
4. S.B. 1484/Public Act 07-185, 2007 Session of the General Assembly (Connecticut, 2007); and H.B. 8002/Public Act 07-2, 2007 Session of the General Assembly, (Connecticut, 2007). Back
5. A17-0001/Fiscal Year 2007 Budget Support Act of 2006, 2007 Session of the City Council (District of Columbia, 2007); and District of Columbia Department of Health. Back
6. Florida Department of Financial Services, "17,497 More Children Insured," Consumer eViews, vol. 4, no.47 (November 23, 2007). Back
7. Hawai'i Covering Kids, "Hawaii Expands Income Limits for Children's Public Health Insurance," Hot Happenings, (October 3, 2006); Act 236, 24th Legislature (Hawaii, 2007). Back
8. H.B 806/Public Act 094-693, 94th General Assembly (Illinois, 2005); for more information, see ALLKids Program. Back
9. Email communication from Theresa Eagleson, Administrator, Division of Medical Programs, Illinois Department of Healthcare and Family Services, December 8, 2007. Back
10. H.B. 1678, 115th General Assembly (Indiana, 2007). Back
11. Conversation with David Roos, Program Director, Covering Kids and Families Indiana, December 3, 2007. Back
12. S.F. 128, 82nd General Assembly (Iowa 2007); Iowa Office of the Governor, "Governor Culver Signs $1 Per Pack Cigarette Tax Increase Into Law," Press Release (March 15, 2007). Back
13. H.B. 542/Act 407, 2007 Regular Session of the State Legislature (Louisiana, 2007). Back
14. Communication with Ruth Kennedy, Medicaid Deputy Director/LaCHIP Director Louisiana Department of Health & Hospitals; Louisiana State Plan Amendment, February 2008. Back
15. Acts of 2006, Chapter 58, 184th Legislature (Massachusetts, 2006). Back
16. Governor Deval Patrick, Testimony before the House Energy and Commerce Subcommittee on Health (February 26, 2008). Back
17. H.F. 1078, 85th Legislature (Minnesota, 2007). Back
18. S.B. 22, 60th Legislature (Montana, 2007). Back
19. H.B. 1-A, 2007 Session of the General Court (New Hampshire, 2007). Back
20. S. 2108/A. 4308, 2007 Session of the State Assembly (New York, 2007). Back
21. New York Office of the Governor, "Governor Spitzer Announces Multi-State Lawsuit To Secure Health Insurance for Children," Press Release (October 1, 2007). Back
22. H.B. 1473, 2007 Session of the General Assembly (North Carolina, 2007). Back
23. J. Romoser, "Delay slows N.C. plans: Child-health tiff pinches budget," Winston-Salem Journal (December 5, 2007). Back
24. H.B. 1463, 60th Legislative Assembly (North Dakota, 2007). Back
25. Email correspondence from Maggie D. Anderson, Director, North Dakota Division of Medical Services Director, February 27, 2008. Back
26. H.B. 119, 127th General Assembly (Ohio, 2007). Back
27. Conversation with Mary Wachtel, Voices for Ohio's Children, February 14, 2008. Back
28. S.B. 424, 51st Legislature (Oklahoma, 2007). Back
29. Email communication from Buffy Heater, Oklahoma, Health Care Authority, January 25, 2008. Back
30. H.B. 2699, 2006 Session of the General Assembly (Pennsylvania, 2006); for more information, see Pennsylvania's SCHIP State Plan Amendment #7 and Cover All Kids Program. Back
31. Email communication from George L. Hoover, Deputy Commissioner, CHIP and AdultBasic Programs, Pennsylvania Department of Insurance, March 7, 2008. Back
32. H. 3620/Act 117, 117th General Assembly (South Carolina, 2007). Back
33. S.B. 3895/Chapter 867 of Public Acts of 2006, 104th General Assembly (Tennessee, 2006); for more information, see Tennessee's current SCHIP State Plan. Back
34. State of Tennessee Department of Finance and Administration, "CoverKids Reaches 15,000 Enrollment Mark," Press Release (November 13, 2007). Back
35. H.B. 109, 80th Legislature (Texas, 2007). Back
36. For more information about implementation, see the Texas Health and Human Services Commission; for more on enrollment, see Children Enrolled in Medicaid, CHIP and CHIP Perinatal Coverage by Month. Back
37. H.B. 150, 2007 General Session of the State Legislature (Utah, 2007). See also Governor Huntsman's budget proposal. Back
38. Voices for Utah Children, "2007 General Session: Child and Family Budget Items of Interest to Voices for Utah Children," (March 2007). Back
39. H. 861/Act 191, 2006 Session of the State Legislature (Vermont, 2006); H. 895, 2006 Session of the State Legislature (Vermont, 2006); for more information on the Catamount Health: The 2006 Health Care Affordability Act, see 2006 Legislative Action on Health Care and Family USA's fact sheet Vermont's Health Reform Laws. Back
40. S.B. 5093, 60th Legislature (Washington, 2007); Washington Office of the Governor, "Governor Gregoire Signs Legislation to Give More Children Access to Health Care," Press Release (March 13, 2007). Back
41. H.B. 4021, 77th Legislature (West Virginia, 2006); for more information, see West Viginia CHIP. Back
42. S.B. 40/Act 20, October 2007 Special Session of the Legislature (Wisconsin, 2007). Back
43. For more information about CMS's approval of BadgerCare Plus, see "CMS Announces Approval of Key Changes to Wisconsin's BadgerCare Program." Back