That said, the wind down of the enhanced match places some state CHIP programs in jeopardy. Most notably, Arizona faces a freeze or termination of its KidsCare program if its state legislature does not act to remove a sunset trigger if the percentage point enhanced match ends.
Other states face similar predicaments. Robust advocacy in these states is underway and needs our support. At the federal level, children and families continue to need our advocacy—and we will not rest until all families have access to the health care they need to be healthy.
We will continue to provide support to our immigration partners as they work for a Dreamer solution. We will continue to fight for funding and sustainability for community health centers and key programs that provide vital health services and supports to our communities. We will continue to demand that health care remains central to debates about the future of this country as so many families go without needed health services. See Appendix Table 1 for state data. Remaining funds available to states, including redistribution funds, are limited and anticipated to run out soon.
However, once states exhaust those funds, no additional funds will be available unless Congress enacts legislation. As of December 6, , nine states have exhausted their FY allotments and have received redistribution funds from CMS to continue coverage. A third of states anticipate exhausting funding by the end of January Figure 1.
Among the 48 states 2 that provided an estimate of when they will exhaust federal funds, including the 38 states that provided an update in November , 16 states projected they will exhaust federal funds by the end of January , and an additional 21 states projected they will exhaust federal funds by the end of March State projections are fluid and change as enrollment and costs fluctuate and states receive redistribution funds.
The majority of states will face a budget shortfall without an extension of federal funds because nearly all states assumed continued federal CHIP funding in their state fiscal year SFY state budgets. Regardless of how states implement their program, they receive the enhanced relative to Medicaid matching rate for CHIP coverage, which was further increased by 23 percentage points under the Affordable Care Act ACA. Many states with separate CHIP programs are planning to reduce coverage in response to the loss of federal funding, and several plan to begin notifying families before the end of the year.
As of July , 32 states and D. Some states use state funding to cover children regardless of immigration status. States are provided with several policy options for streamlining enrollment. Express lane eligibility allows states to rely on eligibility determinations made by other public programs e. This approach provides administrative efficiencies while simultaneously preventing families from having to provide the same information to multiple agencies.
Presumptive eligibility PE allows qualified entities e. PE allows eligible individuals to get immediate coverage of health services while the regular application process is completed.
PE is open to pregnant women, children, and adults. As of , states are expected to rely on trusted electronic data sources rather than paper documentation to verify eligibility.
The only eligibility criterion that federal law requires families to document is immigration and citizenship status. Under the ACA, state agencies can review eligibility no more often than once every 12 months. Additionally, states can provide children with a full months of coverage , regardless of fluctuations in income, through the continuous eligibility option.
Beginning in , states are expected to automatically renew enrollees by determining eligibility based on a review of existing data. Most states have a combination program. In order to keep insurance affordable for families, CHIP limits premiums and cost sharing.
Families with children enrolled in stand-alone CHIP plans can be charged premiums, copayments, deductibles, and other fees up to 5 percent of their household income. The restrictions on out-of-pocket spending can make a significant difference for families that would not qualify for cost-sharing assistance for marketplace plans as a result of their income level.
0コメント