Cost Sharing

States may impose cost sharing (i.e., deductibles, coinsurance, and co-payments) for some children enrolled in CHIP, within federal guidelines.

In general, states cannot adopt cost sharing or premium policies that impose costs that exceed five percent of family income or that favor higher-income families over lower-income families. They also are prohibited from imposing cost sharing for well-baby and well-child care, including immunizations. Finally, states cannot count money raised through premiums or cost sharing as state dollars for purposes of meeting the block grant's 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.