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Health Insurance Flexibility and Accountability (HIFA)
Demonstration Initiative

Introduction

The Administration invites States to participate in the Health Insurance Flexibility and Accountability (HIFA) demonstration initiative, a newly developed Medicaid and State Children's Health Insurance Program (SCHIP) section 1115 waiver approach. The primary goal of the HIFA demonstration initiative is to encourage new comprehensive state approaches that will increase the number of individuals with health insurance coverage within current-level Medicaid and SCHIP resources. The Administration puts a particular emphasis on broad statewide approaches that maximize private health insurance coverage options and target Medicaid and SCHIP resources to populations with income below 200 percent of the Federal poverty level (FPL).

This guidance provides the general parameters for HIFA demonstration projects. Within these parameters, States will be provided flexibility to determine their own approaches in exchange for demonstrating increased health insurance coverage in the State. States will be asked to systematically track the impact of their HIFA demonstration on the uninsured rate for individuals with incomes under 200 percent of the FPL.

Through the HIFA demonstration project, we hope to work with States to:

  • Encourage innovation to improve how Medicaid and SCHIP funds are used to increase health insurance coverage for low-income individuals.
  • Give States the programmatic flexibility required to support approaches that increase private health insurance coverage options.
  • Simplify the waiver application process by providing clear guidance and data templates.
  • Increase accountability in the State and federal partnership by ensuring that Medicaid and SCHIP funds are effectively being used to increase health insurance coverage, including substantially more private health insurance coverage options.
  • Give priority review to State proposals that meet the general guidelines of the HIFA demonstration project outlined below.

Guidelines for States Interested in Applying for a HIFA Demonstration

Inquiries:
Send inquiries to the HIFA information clearinghouse at: HIFA@cms.hhs.gov

Last Modified on Thursday, September 16, 2004