Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost Sharing Policies as of January 2017: Findings from a 50-State Survey


This annual report presents Medicaid and CHIP eligibility, enrollment, renewal and cost sharing policies as of January 2017, and identifies changes in policies that occurred between January 2016 and 2017. As discussion around potential repeal of the Affordable Care Act (ACA), broader changes to the financing and structure of Medicaid, and reauthorization of CHIP unfold, this report offers an in-depth profile of eligibility, enrollment, renewal, and cost sharing policies in each state as of January 2017. This information may serve as a baseline against which future policy changes may be measured.

This report has documented state implementation of changes to Medicaid since the ACA was implemented in 2014, including the Medicaid expansion to low-income adults, changes to eligibility rules, and modernization and streamlining of enrollment and renewal processes. These changes have led to increases in Medicaid and CHIP enrollment, which rose by 17 million between Summer 2013 and October 2016,1 and helped reduce the nation’s uninsured rates to historic lows of 10% for the overall population under age 65 and 5% for children as of June 2016.2 This year’s survey finds continued state efforts to expand access to coverage for some groups and to implement the streamlined enrollment and renewal processes outlined in the ACA.

This report is based on a telephone survey of state Medicaid and CHIP program officials conducted by the Kaiser Commission on Medicaid and the Uninsured and the Georgetown University Center for Children and Families during Fall 2016. It includes findings in three key areas: Medicaid and CHIP Eligibility, Enrollment and Renewal Processes, and Premiums and Cost Sharing. State-specific information is available in Appendix Tables 1 to 21 at the end of the report. This report includes policies for children, pregnant women, parents, and other adults under age 65; it does not include policies for groups covered through Medicaid eligibility pathways for seniors and individuals with disabilities.

Executive Summary Medicaid and CHIP Eligibility

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