June 16, 2006

Governor Revises SCHIP Affordability Standard
On June 15, Gov. Matt Blunt announced the state Medicaid agency will revise its eligibility criteria for coverage under the State Children’s Health Insurance Plan.The change is projected to add 5,418 children to the SCHIP rolls in state fiscal year 2007 at a cost of $1.8 million in state funds.The emergency regulation that will make the change is effective July 1.

Under current law, if children at or above 150 percent of the federal poverty level has access to “affordable” coverage, then they are ineligible for SCHIP. Coverage is deemed affordable if it costs less than 133 percent of the average premium for coverage under the health plan that covers most state employees. At present, this is nearly $375 per month.

Before Aug. 28, 2005, this affordability standard only applied to children with household incomes between 225 percent and 300 percent of the federal poverty level. In revising Medicaid eligibility standards during the 2005 legislative session, the Missouri General Assembly applied the same affordability standard to applicants with household incomes above 150 percent of the federal poverty level.

The new regulation will discard the fixed affordability standard tied to state employee health plan premiums. Instead, coverage will be deemed affordable if it costs less than 9 percent of a household’s net income.

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