On August 17, 2007, the Centers for Medicare and Medicaid Services issued a SCHIP directive, imposing new conditions on states that want to offer affordable SCHIP coverage to children over 250 percent of the federal poverty level. This issue brief details the policy changes under the directive and the implications they will have on states and children.

On February 4, 2009 President Obama rescinded the August 17 Directive. CMS issued a letter to state health officials on February 6, 2009, withdrawing the directive and the clarifying letter.