The third session in the Medicaid 101 series, Federal and State Partnerships for Children’s Health shared the differences between Medicaid programs and the Children’s Health Insurance Program (CHIP).
Maureen Hensley-Quinn, senior program director at the National Academy for State Health Policy, provided an overview of Medicaid and CHIP.
“Established 30 years apart from each other, there is a federal match difference. CHIP is a bit higher than Medicaid when it comes to kids and pregnant women,” Hensley-Quinn said. “Medicaid is an entitlement program and CHIP is a block grant program.”
She went on to explain that CHIP includes a regulation requiring families to pay 5% of cost sharing in their child’s coverage.
“The children’s uninsured rate in 1997 was 15%. In 2016, we hit an all-time low of 4.7% in 2020 it was 5.6%,” she said.
Hensley-Quinn turned to Rene Mollow, deputy director for health care benefits and eligibility at the California Department of Health Care Services.
“In California, we have a combo, Medicaid/CHIP program,” Mollow said. “In California, today we leverage our entire Medicaid delivery program. We work to try and minimize the complexities.”
Mollow was able to provide one option made available to unborn children.
“CHIP does offer the option of covering the unborn, so then you do not have to look at citizenship status, CHIP does not allow immigrants to be covered,” she said. This coverage is only extended to the unborn child and not the mother.
Susana Penate, senior policy advisor at Texas Health and Human Services Commission, was on hand to discuss the way Texas manages care.
“In Texas 65% of Medicaid beneficiaries are healthy children. The child must be under 19, depending on their age, they are income requirements. As far of eligibility, its 12 months (of coverage). The first six months it’s continuous, second six months there are periodical income checks,” she said, noting this rule will change in the coming year.
The two states are a small sampling of programs across the country.
“As you can tell, these two different authorities have become very similar over time. States have been incredibly thoughtful and strategic in how they leverage these programs. Both Texas and California are great examples of states doing that,” said Hensley-Quinn.