Eligibility Changes To The Children’s Health Insurance Program

PUBLIC NOTICE: 
SOUTH CAROLINA DEPARTMENT OF HEALTH AND HUMAN SERVICES

 

Program (CHIP), implemented in accordance with The Patient Protection and Affordable Care Act of 2010 (ACA).

Effective on or after January 1, 2014, SCDHHS will amend the South Carolina State Plan for Medical Assistance, to be in compliance with federally mandated reforms that support South Carolina’s healthcare initiatives aimed at improving health and health outcomes.

The ACA mandates the use of Modified Adjusted Gross Income (MAGI) methodology for eligibility determination for certain groups of Medicaid applicants and beneficiaries.  Existing Medicaid Children’s Health Insurance Programs must convert their existing income standards (Medicaid CHIP Federal Poverty Levels (FPL)) to MAGI-equivalent standards.  Effective January 1, 2014, the minimum qualifying income level for Medicaid is increased to 133% FPL for children ages 6 up to 19, making 133% FPL the minimum income level for all children under 19.  South Carolina must submit a state plan amendment to reflect revised income standards to be in compliance with this requirement.  States may continue to receive Title XXI funding for children transitioning to Medicaid and also receive Title XXI funding for children newly eligible for Medicaid as a result of this requirement.  All other Medicaid rules under the state’s Medicaid plan apply. 

The following table reflects these changes:

 

Category

2013 FPL Limit

2014 FPL Limit

Children

200%

208%

Children 0-1

185%

194%

Children 1-5

133%

143%

Children 6-18

100%

133%

 

The Children’s Health Insurance Program provides coverage for eligible, uninsured children whose household income is between the FPL for their age and 208%.  

Budget Impact: CMS anticipates that the MAGI methodology and converted income limits will be cost neutral.

Copies of this notice are available at each County Department of Health and Human Services Office and at www.scdhhs.govfor public review.  Additional information regarding this action is available upon request at the address cited below.

Any written or e-mailed comments submitted may be reviewed by the public at the SCDHHS, Medicaid Eligibility, Enrollment and Member Services Jefferson Square Building, 1801 Main Street, Columbia, South Carolina, Monday through Friday between the hours of 9:00 A.M. and 5:00 P.M.

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