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State Children’s Health Insurance Program

State Children’s Health Insurance Program. created through the Balance Budget Act of 1997 to cover uninsured children Title XXI of the Social Security Act gave states options how to establish programs Idaho choose to expand Medicaid rather than create a separate program.

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State Children’s Health Insurance Program

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  1. State Children’s Health Insurance Program • created through the Balance Budget Act of 1997 to cover uninsured children • Title XXI of the Social Security Act gave states options how to establish programs • Idaho choose to expand Medicaid rather than create a separate program

  2. While the benefits and administration are the same, eligibility differs

  3. Funding match rate higher under Title XXI • @70% is paid by the federal government under traditional Medicaid/Title XIX • @80%of all benefits paid under the expansion is paid by the federal government

  4. Enrollment has slowed

  5. We’ve made some progress, but have we met the needs of uninsured children in Idaho? Data analysts tell us that approximately 18% of Idahoans are uninsured, of which 24% are children.

  6. Are the resources available to address the need? Federal allotments remain sufficient to support CHIP, however state general funds will be needed.

  7. Initial CHIP Task Forcerecommendations revisited • Graduated voucher system for incomes up to 200% FPL • Change provider reimbursement methodology with some increases • Implement cost sharing • Screen for creditable insurance coverage • Pursue public/private partnerships

  8. Idaho State Planning Grant initiatives have included common elements supported by CHIP Task Force • Moving eligibility to 200% FPL over time • Reflecting a public/private partnership with both participating in the funding • Reimbursing providers through commercial products • Implementing cost sharing

  9. Current federal priorities- • Supports public/private partnerships • Encourages states to expand program to address the uninsured • Reduces administrative barriers through a streamlined waiver application process

  10. Current federal requirements- • Mandatory populations may not have benefits reduced and can only be subjected to nominal cost sharing. • Optional and expanded Medicaid populations can be included in demonstration waiver programs that allow greater flexibility.

  11. Health Insurance Flexibility & Accountability Waiver For demonstration populations: • Flexible benefit designs for optional and CHIP eligible clients and services • cost sharing allowances including premiums and co-pays • encourages integration with private health insurance options • budget neutral over 5 years

  12. Kate Vanden Broek will now present an overview of the Idaho State Planning Grant which will include a review of the Access Card. Kate & I will be happy to answer your questions at the conclusion of her presentation. Thank you!

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