By Martha Heberlein
Click on a state below to view information on the eligibility and enrollment and retention procedures of state Medicaid/CHIP programs for children, parents, and pregnant women in effect as of January 1, 2013. You can also view a snapshot of the data or download all state tables.
Data are provided from a national survey conducted by CCF with the Kaiser Commission on Medicaid and the Uninsured. View the full 2014 survey, Modern Era Medicaid: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal and Cost-Sharing Policies.
NOTE: New MAGI-equivalent eligibility thresholds are now in effect. For details on the conversion, please see Modern Era Medicaid. For eligibility thresholds as of October 1, 2014, see Medicaid/CHIP Eligibility Limits, 2014.
As of January 1, 2015 in Medicaid and CHIP:
- 48 states cover children at of above 200 percent of the FPL through Medicaid and CIP; 19 states cover children at or above 300 percent of the PFL
- A total of 33 states cover pregnant women at or above 200 percent of the FPL
- 21 states eliminated waiting periods in CHIP
- 33 states have no period of time that a child must be without group coverage prior to enrolling; in addition, 28 states have now eliminated the five-year waiting period for lawfully residing immigrant children, while 23 have done so for pregnant women
- Among states that expanded Medicaid, the median eligibility level for both parents and other adults is 138 percent of the FPL. However, among the 23 states that have not expanded, the median eligibility level is just 45 percent of the FPL for parents and 0 percent of the FPL for childless adults
- Individuals can apply online for Medicaid at the state level in all but one state, and the majority of states are accepting Medicaid applications by phone
- 36 states provide individuals the opportunity to create an online account for management of their Medicaid coverage
- States have established eligibility verification policies that seek to rely on electronic data and minimize paperwork for individuals; 40 states verify income prior to enrollment and 11 verify after
- The ACA calls for highly automated, paperless renewal procedures for Medicaid and CHIP. During the transition to this process, CMS offered states an option to temporarily delay renewals, which 34 states took up I Medicaid and 22 states took up in CHIP during 2014
- 28 states authorize entities to conduct presumptive eligibility determinations for children, pregnant women, parents, or other adults
- 30 states charge premiums or enrollment fees for children, primarily in CHIP; 26 states have cost-sharing for children
- No state charges premiums for parents or ACA expansion adults in traditional Medicaid
- Four states (AR, IA, MI, and PA) have received waiver approval to charge monthly payments not otherwise allowed under federal rules for some adults
- Most states charge nominal cost-sharing for low-income parents and expansion adults
All State Tables
- Coverage of Lawfully-Residing Immigrant Children and Pregnant Women without a 5-Year Waiting Period (ICHIA Option), January 2013