Proposed Changes to the Children’s Health Insurance Program

The South Carolina Department of Health and Human Services (SCDHHS)
gives notice of the following proposed actions pursuant to the requirements
of Title 42 CFR 435.118 regarding eligibility changes to the Children’s Health
Insurance Program (CHIP), implemented in accordance with The Patient Protection and
Affordable Care Act of 2010 (ACA).
Effective on or after January 1, 2014, SCDHHS proposes to 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
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%.
Proposed 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 for public review. Additional
information regarding these proposed actions is available upon request at
the address cited below.
Written comments may be sent to Medicaid Eligibility, Enrollment and Member
Services, SCDHHS, Post Office Box 8206, Columbia, South Carolina 29202-8206.
Comments may also be submitted to Written and e-mailed
comments must be received by close of business December 19, 2013.
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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