Department of Health and Human Services
HHS Logo Bottom
HHS Yellow Bar

News Release

FOR IMMEDIATE RELEASE
Thursday, Nov. 4, 2004

CMS Public Affairs
(202) 690-6145

HHS Approves Idaho Request to Help SCHIP Families Buy Employer Based Insurance

HHS Secretary Tommy G. Thompson today announced the approval of Idaho's request to help families of children in the State Children's Health Insurance Program (SCHIP) buy health insurance through their employers.

"By giving states like Idaho greater flexibility in their Medicaid and SCHIP programs, we are creating new opportunities for low-income residents to obtain the health coverage that they need," Secretary Thompson said.

The so-called premium assistance program will help an estimated 1,400 SCHIP-eligible children with family incomes at or below 185 percent of the federal poverty level (FPL), under the Administration's Health Insurance Flexibility and Accountability (HIFA) Initiative.

"As a physician, I know how important it is for young children to have access to routine, preventive medical care," said Mark B. McClellan M.D., Ph.D., administrator of the Centers for Medicare & Medicaid Services, the agency within HHS that oversees the SCHIP program. "This new plan will help more kids receive the kind of care that can prevent long-term health care problems."

Under the demonstration, Idaho expects to provide enrollees eligible for SCHIP with the option of enrolling in a premium assistance program called the Access Card Program. Enrollment in the premium assistance program is in lieu of receiving benefits through the state plan.

Idaho operates a combination SCHIP program, which is made up of a SCHIP Medicaid expansion program called CHIP A (covers children at or below 150 percent of the FPL) and a separate SCHIP program called CHIP B (covers children above 150 through 185 percent of the FPL).

Enrollment in the Access Card program allows a family to purchase private or employer-sponsored insurance for a child, and the state will reimburse an eligible participant's premium up to $100 per month or up to $300 per month per family (or up to three children). Reimbursements of premium assistance subsidy payments are paid directly to an insurance company participating in the Access Card Program. Enrollment in a private or employer-sponsored plan is voluntary and families may elect to switch to direct state coverage at any time.

For Families who choose the Access Card, the benefit package will depend on the private insurance purchased by the family. There is no minimum benefit package required by the state. For those CHIP A enrollees who choose direct coverage, the standard Medicaid benefit package will be provided, and for those CHIP B families who choose direct coverage, the Title XXI Secretary-approved benefit package will be provided.

The HIFA initiative is a Medicaid and SCHIP waiver approach recently developed by the Bush Administration to encourage states to expand access to health care coverage for low-income individuals through Medicaid and SCHIP demonstrations. The initiative gives states more flexibility to coordinate these companion programs and offers a simpler application for states that commit to reducing the number of people without health insurance. HIFA also encourages coordination between public and private coverage options for the uninsured.

As former governors, President Bush and Secretary Thompson have made it a priority to make it simpler and easier for governors to submit Medicaid and SCHIP waiver requests and to have those requests considered promptly. Since January 2001, HHS has approved waivers and plan amendments that have expanded eligibility to more than 2 million people and enhanced benefits for more than 6 million people.

More information about the HIFA initiative, including an online template that states can use to submit applications, is available at http://www.cms.hhs.gov/hifa/.

###


Note: All HHS press releases, fact sheets and other press materials are available at http://www.hhs.gov/news.

Last Revised: November 4, 2004

HHS Home | Questions? | Contact HHS | Site Map | Accessibility | Privacy Policy | Freedom of Information Act | Disclaimers

The White House | FirstGov