Cost Sharing

States may impose cost sharing for some children enrolled in Medicaid, within federal guidelines. Except for "mandatory children" a state may impose premiums for children, with some limitations based on family income. Co-payments are also allowed, with some restrictions for children with family incomes up to 150% of the federal poverty level. States cannot count money raised through premiums or cost sharing as state dollars for the purposes of meeting the federal matching requirements.

Research has shown that premiums in Medicaid and CHIP depress enrollment because of the financial burden they impose on families, potentially increasing the number of uninsured children.