Potential Cuts To Chip Funding
CHIP has struggled to maintain its funding too. Federal funding for the program was set to expire in September 2017. Congress approved a stop-gap measure in December 2017 to extend funding into March 2018. It was not until January 2018 that Congress passed a more long-term solution, a retroactive six-year extension through 2023.
That very same legislation also decreases the federal matching rate over time. Any enhanced FMAP rates for CHIP that were established by the Affordable Care Act would be reduced to the regular federal match rate by 2021. With less money put into the program, fewer children may be covered.
While block grants are currently used for the CHIP program, the CHIP program is significantly smaller in scale than Medicaid. Block grants limit how many children can be covered under the CHIP program. This explains why 15 states currently have waiting lists for CHIP.
In May 2018, the White House presented a rescission proposal that would cut $7 billion from CHIP. The proposal was not approved by Congress.
Income Guidelines For Children’s Medicaid
Your income is the money you get paid before taxes are taken out. Find your family size on the table below. If your monthly income is the same or less, your child might get Children’s Medicaid.
| Family Members | Monthly Family Income |
|---|
| For each additional person, add: | $791 |
*A family of one might be a child who does not live with a parent or other relative.
Federal Funding For Medicaid
When it comes to Medicaid, the federal government matches state spending “dollar for dollar,” at least in concept. It uses what are known as Federal Medical Assistance Percentages to determine how much it will pay. FMAPs take into account a state’s average income relative to the national average.
Each state is given an FMAP of at least 50 percent, i.e. the federal government pays 50 percent of Medicaid costs. All other states receive a higher percentage of Medicaid funds based on their calculated FMAP. With the lowest per capita income level, Mississippi will have a 2021 FMAP of 77.76% so that the federal government contributes $3.50 for every $1 the state spends.
In order to get federal Medicaid funding, the states agree to certain terms. The state is not permitted to put people on waiting lists, it cannot have an enrollment cap, and it cannot charge for premiums or copayments for anyone earning less than 150 percent of the FPL.
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Differences In Coverage For Medicaid And Chip
Federal regulations mandate Medicaid offer specific services to its covered children. This includes Early and Periodic Screening, Diagnosis and Treatment , comprehensive services which focus on preventive care and wellness. It includes the following:
- Comprehensive history review
- Mental health assessments and counseling
- Physical examinations
- Vision evaluations, including eyeglasses
Services also covered by Medicaid include care provided at Federally Qualified Health Centers as well as rehabilitation services.
CHIP programs, however, do not have to meet the standard set by EPSDT, although they must provide benchmark care that includes hospital care, laboratory studies, X-rays, and well-child examinations, including immunizations.
Dental care may not be as extensive as that offered under EPSDT but must be part of the included benefit package. To this end, each state can choose their dental benefit based on the most popular state employee dental plan, the most popular federal employee dental plan for dependents, or coverage from the most popular commercial insurance plan in the state.
Medicaid Vs Chip: An Overview
Medicaid and Childrens Health Insurance Program both play a critical role in ensuring that children in lower-income families have sufficient health care coverage. Although they are both federal programs largely implemented through the states with joint financing, the two programs differ in many respects.
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Federal Funding For Chip
Federal funding for CHIP, on the other hand, has pre-set limits. Each state is given an allotment every year as a block grant. The dollar amount is fixed regardless of the number of people covered by the program.
The 50 states and the District of Columbia have a choice to use their block grants in one of three ways:
- As a combination Medicaid-CHIP program
- As part of the state’s Medicaid expansion
- As a separate CHIP program
To encourage states to participate in CHIP, the federal government offers a higher matching rate than it does for Medicaid. This is referred to as the enhanced Federal Matching Assistance Percentages . The minimum for Medicaid matching in 2020 is 50 percent but all states are 65% or higher. Again, states with higher economic needs get reimbursed at an even higher rate.
Those states using combination programs or Medicaid expansion have the same program requirements as traditional Medicaid. States with separate CHIP programs, however, have more wiggle room. If need be, they can put children on waiting lists or establish enrollment caps to rein in CHIP costs. Many of those states will also charge premiums and copayments to their beneficiaries.
How Does Medicaid Work
State Medicaid programs are required to adhere to federal guidelines. Costs and coverage may differ between the states.Medicaid programs may pay for the beneficiarys care directly. Some beneficiaries have zero out-of-pocket costs for their medical and dental care.Other Medicaid programs work with private insurers to provide coverage to beneficiaries.
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How Does Chip Work
CHIP provides health care to children who qualify. If your child qualifies, you will need to select a health plan and the doctor you want for your childs health-care needs. Pick Texas Childrens Health Plan to select from our doctors.
Your childs doctor can help you find a specialist if your child needs one. The most a family will pay is $50 per year for all the children who qualify, but most families pay $35 per year or less. You will also need to pay additional co-payments for some services.
How To Apply For Medicaid And Chip
Determining qualification for Medicaid or CHIP is a rather straightforward process. There is an income calculator on the healthcare.gov Medicaid page to determine qualification based on income. This is a useful tool but does not automatically determine eligibility.
One way to apply for Medicaid and CHIP is through the Health Insurance Marketplace. Once you submit an application, your state agency will contact you regarding enrollment. At the time of application, you will also learn if you qualify for an individual plan as well, possibly with some savings based on income.
Parents, grandparents, guardians or other legally authorized representative can apply for benefits on behalf of a child. Teenagers living on their own may also apply for themselves, or any adult may apply for them.
The second way to apply for Medicaid and CHIP is through your state’s Medicaid agency. Following this link will allow you to select your state. Once your state is selected, you will be able to follow a provided URL that directs you to the Medicaid homepage for your state’s Medicaid agency.
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Children’s Health Insurance Program
CHIP is designed to provide health care insurance for children in families without health insurance or with inadequate health insurance. It does not replace Medicaid in fact, children on Medicaid are precluded from CHIP participation. A coalition of public, non-profit and private health-related organizations is committed to improving the health of Mississippi’s children.
Potential Cuts To Medicaid Funding
The Trump administration attempted to repeal the Affordable Care Act and replace it with the American Health Care Act, subsequently known as the Better Care Reconciliation Act in 2017. This legislation did not pass but it would have ended Medicaid expansion and would have also changed how Medicaid was funded. According to the Congressional Budget Office, the BRCA would have cut $756 billion from Medicaid over a decade and 15 million people on Medicaid would have lost coverage as a result.
The BCRA did offer tax credits for individuals and families. In this way, it can be argued that attempts were made to decrease the cost of health care to Americans. Specifically, the BCRA would have replaced the ACA-income-based tax credits with a flat tax credit adjusted for age. In some cases, the subsidies would be greater under the BCRA than the ACA, but these subsidies were capped at $14,000 per year regardless of family size. Also, anyone who was eligible for an employer-sponsored health plan, Medicare, Medicaid or CHIP, or TriCare, would not have been eligible for those tax credits.
Attempts are still underway to repeal the Affordable Care Act. With the individual mandate deemed unconstitutional in 2017, a federal court judge in Texas ruled in 2018 that the Affordable Care Act as a whole is unconstitutional. That ruling is under appeal and may eventually make its way to the Supreme Court. Until then, the Affordable Care Act remains in effect.
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What Income Level Must I Have To Qualify For Medicaid
The answer to this question isit depends on where you live.If your residential state expanded Medicaid during the Obama administration, you may qualify for Medicaid based on your income. If your Medicaid Office didnt expand its program, existing rules are used to determine your eligibility. Your family statuse.g. caring for a young child/children or pregnancy, annual income, family/household size, age, disability, and other criteria are considered.Each familys needs and situation differ. Complete a Medicaid application to learn if you qualify.
Chip Does Not Cover Long
If you have a child with a disability and make too much money to get Medicaid, you might be able to get coverage through the Medicaid Buy-In for Children program. MBIC allows families of children with disabilities to make a monthly payment to get Medicaid coverage.
Learn about other programs and services for people with disabilities.
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See If Your Children Qualify And Apply For Chip
Each state program has its own rules about who qualifies for CHIP. You can apply right now, any time of year, and find out if you qualify. If you apply for Medicaid coverage to your state agency, youll also find out if your children qualify for CHIP. If they qualify, you won’t have to buy an insurance plan to cover them.
Considerations For Chip Reauthorization
CHIP reauthorization will be considered within the broader context of coverage and changes from the ACA. CHIP is funded through FY 2015, so Congress will soon need to consider CHIP reauthorization. Since CHIP was reauthorized in 2009, the ACA has altered the health care landscape by expanding Medicaid eligibility for children to 138% FPL and establishing tax credits and new options for coverage under the new health insurance Marketplaces.
If CHIP is not reauthorized, some children will face barriers to coverage. If Congress does not reauthorize CHIP, Medicaid expansion CHIP programs will be subject to the maintenance of eligibility requirements through FY 2019 and children in separate CHIP programs could transition to Marketplace coverage, if the Secretary of HHS certifies that this coverage is at least comparable to CHIP in terms of benefits and cost-sharing. However, some children will not be eligible for tax credits because a parent may have access to affordable employer coverage however, the affordability test for employer coverage is based on a calculation of the individual coverage relative to a workers wages . This situation is referred to as the family glitch and could leave more children uninsured.
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Health Coverage For Children Under The Aca
Under the ACA, eligibility for children through Medicaid and CHIP remains strong. The ACA requires states to use a uniform definition of income, called Modified Adjusted Gross Income , to better coordinate eligibility across health care programs. Using MAGI, more than half of the states cover children in families with incomes at or above 250% FPL and 19, including DC, cover children in families with incomes at or above 300% FPL . The ACA protects the gains already achieved in childrens coverage by requiring states to maintain eligibility thresholds for children that are at least equal to those they had in place at the time the law was enacted through September 30, 2019.
Figure 5: Childrens Eligibility for Medicaid/CHIP by Income, January 2014
While all states have already significantly expanded coverage to children through Medicaid and CHIP, not all eligible children are enrolled in the program due to lack of parent knowledge about their eligibility and historic enrollment barriers. Over 5.2 million of the 14 million currently uninsured individuals who are estimated to be eligible for Medicaid in 2014 are children.16 In states not implementing the Medicaid expansion, children account for 75% of the uninsured eligible for Medicaid or CHIP .
Figure 6: Uninsured Adults and Children Eligible for Medicaid / CHIP, 2014
Chip Medicaid Kept Children Insured
Data released today show the number of U.S. children without health insurance declined for the first time in at least four years in 2021, aided by government policies that helped maintain their access to medical care.
Just under 4 million children or 5% of all U.S. children went without health insurance in 2021, according to new data from the U.S. Census Bureau, a 0.6 percentage-point drop from 2020. The figure represents 475,000 children who gained or retained insurance in 2021, largely due to increased public coverage through Medicaid or the Childrens Health Insurance Program, which took over as job losses and other economic issues decreased childrens private coverage.
Insuring our nations 73 million children and keeping them insured offers one of the best investments we can make in their health and well-being, said First Focus on Children President Bruce Lesley. We are pleased to see this decline in the number of children who go without insurance and Congress must move quickly to cement these gains. Congress also must make permanent the Childrens Health Insurance Program. CHIP, which insures 10 million children each year, is the only federal health insurance program that requires constant renewal. When Congress allows it to expire as they did in 2017 they endanger the health care of the next generation.
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Complete And Submit An Application
Self-service application options:
Online: Log on to Georgia Gateway at to apply for benefits. Available 24/7.
Call the Customer Contact Center at to submit an application by telephone.
An application is considered filed when it has the name of the head of household, address, date and signature of the head of household or another household member and is received by DFCS.
Notice of Free Interpretation ServicesIf you have difficulty communicating with us because you do not speak English or have a disability, please notify a staff person. Free interpretation services, translated materials or other assistance is available upon request.
For additional support with requesting large print versions of DFCS applications, please visit .
DFCS Reasonable Modifications and Communication Assistance Request Form for Persons with Disabilities
Do you have a disability and need a reasonable modification or communication assistance to access DFCS services? to request a reasonable modification, communication assistance, extra help or to learn more about the rights of customers with disabilities.
Medicaid Benefit Renewal
All benefits recipients are required to undergo periodic review of continued program eligibility. A renewal form and any required accompanying verification can be submitted in Georgia Gateway or by using Form 508 the FOOD STAMP/MEDICAID/TANF Renewal Form.
Health Coverage Of Children Pre
Experience with Medicaid and CHIP demonstrates that the combined effects of eligibility expansions, enrollment simplifications, and outreach efforts lead to increased coverage and reductions in the number of uninsured children over time. Medicaid provides the foundation of coverage for poor and near poor-children. CHIP was created in 1997 as a complement to Medicaid to provide coverage to uninsured children who were not eligible for Medicaid. CHIP, which provided states some flexibility on program design, as well as a higher federal match rate compared to Medicaid, helped spur efforts to expand eligibility to reach more low-income children, adopt strategies to simplify enrollment and renewal processes and conduct outreach and enrollment efforts. A year ahead of the implementation of the ACA, median eligibility levels for children were 235% FPL and states had adopted an array of enrollment simplification procedures to make it easier for children to obtain and maintain coverage. As a result of these combined efforts, Medicaid and CHIP have helped to reduce the uninsured rate for children to a record low of 7% in 2012. Coverage gains continued for children during the recent economic downturn when uninsured rates for adults climbed .
Figure 1: Uninsured Rates Among Nonelderly Adults and Children, 1997-2012
Figure 2: Uninsured Rates for Children by State, 2011-2012
Figure 3: Health Insurance Coverage of Children by Income and Race, 2012
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Ways To Apply For Chip:
- Fill out an application through the Health Insurance Marketplace®. If it looks like anyone in your household qualifies for Medicaid or CHIP, well send your information to your state agency. Theyll contact you about enrollment. When you submit your Marketplace application, youll also find out if you qualify for an individual insurance plan with savings based on your income instead. Create an account or log in to an existing account to get started.
FYI: Apply any time
You can apply for and enroll in Medicaid or CHIP any time of year. Theres no limited enrollment period for either Medicaid or CHIP. If you qualify, your coverage can start immediately.
Medicaid Eligibility For Children
Children raised in families earning 138 percent or less of the federal poverty level per year are eligible for Medicaid. The FPL is calculated by the U.S. Department of Health and Human Services every year and is based on the number of people in a family with consideration also given to location. After all, some states are much more expensive to live in than others, like Hawaii.
Before the Affordable Care Act , i.e., Obamacare, was passed in 2010, children became eligible for Medicaid based on both their age and family income. Generally speaking, the older a child got, the less likely he was to get Medicaid coverage for the same family income. Oddly enough, this meant that only some children within the same family might be covered in any given year. The new legislation made the income eligibility standard the same for children 0 to 19 years of age.
Some states still have different eligibility requirements for different ages groups, but the standard value is now set for at least 138 percent of the FPL for all children. Before the ACA, the eligibility threshold was set at only 100 percent for children between 6 and 19 years old.
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