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New Kaiser 50-State Survey Provides Data on States’ Medicaid and Children’s Health Insurance Program Eligibility Levels and Enrollment, Renewal and Cost-Sharing Policies as of January 2015

A new survey from the Kaiser Family Foundation provides a comprehensive look at where states stand with their Medicaid and Children’s Health Insurance Program (CHIP) eligibility levels and enrollment, renewal and cost-sharing policies as of January 2015, one year into implementation of the Affordable Care Act’s major coverage provisions.

The 13th annual survey, conducted by the Foundation’s Kaiser Commission on Medicaid and the Uninsured and Georgetown University’s Center for Children and Families, finds that states across the country have made it easier to apply for and enroll in the Medicaid program, updating their processes to reflect ACA requirements for a more automated, data-driven, and seamless experience for individuals.

Key findings include:

  • Online Medicaid applications are available in all states, except Tennessee, and the majority of states accept Medicaid applications by phone. States also have established policies that seek to rely on electronic data sources and minimize paperwork burdens to verify information of applicants.
  • States still have continued transition work to do under the ACA , such as enhancing information technology systems, implementing automated renewal processes and improving coordination between Medicaid and the Marketplaces.
  • As of Jan. 1, 30 states charge premiums or enrollment fees and 27 states charge cost-sharing for children. These charges are primarily in CHIP, reflecting the relatively higher family incomes of children covered by the program compared to Medicaid. No states charge premiums for parents or adults newly eligible under the ACA in traditional Medicaid, but most charge nominal cost-sharing for both adult groups.

The survey also provides 2015 eligibility levels in all 50 states and the District of Columbia for children, pregnant women, and non-disabled adults in Medicaid and CHIP. The data document that the 28 states that adopted the ACA Medicaid expansion extend eligibility to parents and other adults up to 138 percent of the federal poverty level ($27,310 for a family of three or $16,105 for an individual), with two of these states extending eligibility for adults to higher levels. Among the 23 states not adopting the expansion at this time, 19 states have eligibility levels for parents that are below poverty and only one state provides Medicaid coverage to childless adults. Eligibility for children is at or above 200 percent of the federal poverty level through Medicaid and CHIP in all but two states and 33 states cover pregnant women at those income levels or higher.

The full report, Modern Era Medicaid: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP as of January 2015, can be found online at kff.org. A public web briefing to discuss the key findings and take questions will be held today at 1 p.m. ET; register here to attend the briefing.

The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
Washington Offices and Barbara Jordan Conference Center: 1330 G Street, NW, Washington, DC 20005 | Phone 202-347-5270

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.