{
  "id": "RL32389",
  "type": "CRS Report",
  "typeId": "REPORTS",
  "number": "RL32389",
  "active": false,
  "source": "EveryCRSReport.com",
  "versions": [
    {
      "source": "EveryCRSReport.com",
      "id": 104336,
      "date": "2004-05-19",
      "retrieved": "2016-04-07T20:15:32.288960",
      "title": "A State-by-State Compilation of Key State Children's Health Insurance Program (SCHIP) Characteristics",
      "summary": "The Balanced Budget Act of 1997 (BBA 97;  P.L. 105-33 ) established the State\nChildren\u2019s Health\nInsurance Program (SCHIP) under a new Title XXI of the Social Security Act. In general, SCHIP\nprovides states with federal matching funds to cover uninsured children in families with income that\nis above Medicaid eligibility levels. To date, the upper income eligibility limit under SCHIP has\nreached 350% of the federal poverty level or FPL (in one state).\n \n States may choose among three options when designing their SCHIP programs. They may\nexpand Medicaid, create a new \u201cseparate state\u201d insurance program, or use a\ncombination of both\napproaches. All 50 states and the District of Columbia have SCHIP programs in operation. As of\nJune 30, 2003, among these 51 jurisdictions, 15 were Medicaid expansions, 18 were separate state\nprograms, and 18 used a combination approach.\n \n Medicaid expansion programs must provide all mandatory benefits and covered optional\nservices offered in the state\u2019s Medicaid program. Cost-sharing is prohibited for children. \nSeparate\nstate programs must follow certain coverage and benefit options outlined in SCHIP law. While\ncost-sharing provisions in separate state programs vary by family income in a number of states, the\ntotal annual aggregate cost-sharing (including premiums, enrollment fees, deductibles, copayments,\ncoinsurance, and other similar charges) for any family may not exceed 5% of total income in a year. \nPreventive services are exempt from cost-sharing.\n \n States must ensure that SCHIP does not substitute for coverage under group health plans, a\nphenomenon known as \u201ccrowd-out.\u201d The primary method for preventing substitution\nis requiring\na waiting period during which applicants must be uninsured prior to enrollment in SCHIP.\n \n States that want to make changes to their SCHIP programs that go beyond what the law allows\nmay do so through what is called a Section 1115 waiver. These waivers allow states to use SCHIP\nfunds to cover populations not normally covered under SCHIP, such as pregnant women and parents\nof SCHIP children, as well as to modify certain statutory provisions such as cost-sharing limitations\nand benefit requirements.\n \n This report provides an overview of state program characteristics under SCHIP in each of the\nareas summarized above (eligibility, benefits packages, cost sharing, crowd-out prevention, and\nSection 1115 waivers). Several sources were used to compile the program data shown in this report. \nThese data represent program status as of December 31, 2002 through July 31, 2003, depending on\nthe source. Information is summarized across states, and detailed, state-specific fact sheets are also\nprovided.",
      "type": "CRS Report",
      "typeId": "REPORTS",
      "active": false,
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      "topics": []
    }
  ],
  "topics": [
    "Domestic Social Policy"
  ]
}