A New Children's Health Insurance Program (CHIPRA 2009)

By Doug Gulleson

Doug Gulleson
Level: Platinum

Doug Gulleson is a full partner in Good Neighbor Insurance. He travels everywhere to find good scuba diving spots and understands the need for adequate ...

The CHIP program has evolved over the years and is another option, via the government, for possible health insurance. However, please note that this government program is not a full blown health insurance plan like you could get through private health insurance companies and thus have limitations and coverage caps, etc. CHIP is a great possible option for those on a lower income or if one cannot get on an individual health insurance plan due to medical underwriting. Below is information on benefits that have been added to the CHIPS program this year.

Shortly after taking office, on February 4, 2009, President Obama signed into law new regulations and extension of benefits (CHIPRA) for an existing children's health insurance program (CHIP).

This act provides health insurance coverage to lower income pregnant women and children who do not qualify for the state assistance program, but who fall within 300% of the federal poverty level (FPL). It is designed to help children in families that earn too much to qualify for Medicaid, but too little to afford private health insurance.

The act was made effective April 1, 2009 and will continue through 2013.

Under this bill more than four million uninsured children will be able to get medical assistance. Increased tobacco taxes will offset the increase in spending which is currently estimated at more than $32 billion over the next four years.

Here are some important highlights of this bill:

- Dental care coverage increases. States must cover dental care under the children's health program. They will also be allowed to provide dental coverage as a supplement to private insurance.

- Legal immigrants qualify for assistance more quickly. Pregnant women and children under 21 are the ones affected. Previously, legal immigrants had to wait five years from the time they entered the United States before they were eligible for medical assistance from Medicaid and the State Children's Health Insurance Program. Now States are able to cover pregnant women and children who are legal immigrants.

- Financial eligibility requirements have been raised. This means more families can be helped. A pregnant woman's financial eligibility is now set at 185% of the Federal Poverty Level; a child under 19 is set at 200% of the FPL. The cap is set at 300%.

- States can choose how they want to implement this increased health coverage. They can expand Medicaid by increasing the maximum family income allowable for children. Or they can expand current health programs by increasing the number of children they will accept into the program or by opening the doors to allow higher-income families to participate. They are also able to establish new programs that comply with federal law. However the States choose to do it, they will receive matching funds from the federal government for the new children enrolled.