Presumptive Eligibility:Medicaid/CHIP - Kaiser State Health Facts

Has Presumptive Eligibility for Medicaid and CHIP, December 2009

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	Presumptive Eligibility	Notes

United States	14 Medicaid, 9 CHIP, 11 Aligned Medicaid and separate CHIP

Alabama	No
Alaska	No	No separate CHIP program.
Arizona	No
Arkansas	No	No separate CHIP program.
California	Medicaid and separate CHIP	In California, the CHIP program has a presumptive eligibility process available to families with income up to 200 percent of the federal poverty line. This process is available through the Child Health and Disability Prevention program provider and the accelerated enrollment process, which provides temporary full scope no cost medical coverage.
Colorado	Medicaid and separate CHIP
Connecticut	Medicaid
Delaware	No
District of Columbia	No	No separate CHIP program.
Florida	No
Georgia	No
Hawaii	No	No separate CHIP program.
Idaho	No
Illinois	Medicaid and separate CHIP	In Illinois, presumptive eligibility is available in children’s Medicaid and CHIP but not in the state-funded expansion program.
Indiana	No
Iowa	Medicaid and separate CHIP	Iowa plans to implement a presumptive eligibility process for children’s Medicaid and CHIP, starting in January 2010.
Kansas	Medicaid and separate CHIP	In Kansas, presumptive eligibility is being piloted at four entities.
Kentucky	No
Louisiana	No	Louisiana has legislative authority to implement presumptive eligibility, but has not implemented it in either Medicaid or CHIP.
Maine	No
Maryland	No	In Maryland, there is an accelerated eligibility process that is available to children who already have an open case for other benefits at a local eligibility office. These children can receive up to three months of temporary eligibility pending a final eligibility determination.
Massachusetts	Medicaid and separate CHIP
Michigan	Medicaid and separate CHIP	In Michigan, presumptive eligibility is available through the electronic application only, and applicants have to be assisted by a trained or qualified entity.
Minnesota	No	No separate CHIP program.
Mississippi	No
Missouri	Medicaid	In Missouri, children eligible for presumptive eligibility must have a gross family income of 150 percent of the federal poverty line or less.
Montana	No	Montana plans to implement a presumptive eligibility process for children by October 2010.
Nebraska	No	No separate CHIP program.
Nevada	No
New Hampshire	Medicaid
New Jersey	Medicaid and separate CHIP
New Mexico	Medicaid	No separate CHIP program.
New York	Medicaid and separate CHIP
North Carolina	No
North Dakota	No
Ohio	No	No separate CHIP program.
Oklahoma	No	No separate CHIP program.
Oregon	No
Pennsylvania	No
Rhode Island	No	No separate CHIP program.
South Carolina	No
South Dakota	No
Tennessee	No
Texas	No
Utah	No
Vermont	No
Virginia	No
Washington	No
West Virginia	No
Wisconsin	Medicaid	In Wisconsin, presumptive eligibility is available for children in families with income up to 150 percent of the federal poverty line.
Wyoming	No

(show/hide notes)

Notes:	Data as December 2009. "Regular" Medicaid refers to coverage under Medicaid eligibility standards for children in place prior to CHIP; states receive "regular" Medicaid matching payments as opposed to enhanced CHIP matching payments for these children.
Sources:	A Foundation for Health Reform: Findings of a 50 State Survey of Eligibility Rules, Enrollment and Renewal Procedures, and Cost-Sharing Practices in Medicaid and CHIP for Children and Parents During 2009. Data based on a national survey conducted by the Center on Budget and Policy Priorities for the Kaiser Commission on Medicaid and the Uninsured, December 2009. Available at http://www.kff.org/medicaid/7855.cfm. 2009 HHS Poverty Guidelines: http://aspe.hhs.gov/poverty/09poverty.shtml.
Definitions:	CHIP: Children's Health Insurance Program. Aligned Medicaid and separate CHIP: Indicates the number of states that have adopted a particular enrollment simplification strategy and have applied the procedure to both their children’s Medicaid program and their CHIP-funded separate program. States that have used CHIP funds to expand Medicaid exclusively are considered “aligned” if the simplified procedure applies to children in the “regular” Medicaid program and the CHIP-funded expansion program.

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