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State Choices to Promote Access

Young children under age 6 who
lack health insurance, 2015

Source1

  • 49 states and the District of Columbia set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for children ages birth to 5. []2
  • 34 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for pregnant women. []2
  • 12 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for immigrant children 0-1yr. []2
  • 6 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for immigrant children 3-5yrs. []2
  • 18 states set the income eligibility limit for public health insurance (Medicaid/SCHIP) at or above 200% of the federal poverty level (FPL) for immigrant pregnant women. []2
  • 28 states [2014]3
  • 23 states [2014]3
  • 30 states provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2017]4
  • 20 states provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2017]4
  • 6 states includes at-risk children in the definition of eligibility for IDEA Part C [2014]5
  • 32 states does not require redetermination of eligibility for Medicaid/CHIP more than once a year [2017]4
  • 32 states has adopted Medicaid expansion as part of the Affordable Care Act [2017]6

State Choices to Promote Quality

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2015]7

  • 18 states 7 Screenings for children <1 year
  • 45 states 4 Screenings for children 1-2 years
  • 51 states 3 Screenings for children 3-5 years
  • 33 states 4 Screenings for children 6-9 years
  • 8 states requires newborn screening for the 31 metabolic deficiencies/disorders and core conditions [2014]8
  

Data Notes and Sources

Last Updated: October 29, 2015

Send us recent developments to update your state's profile.

  1. National data were calculated from the 2011 American Community Survey, representing information from 2011. State data were calculated from the 2009-2011 American Community Survey, representing information from the years 2009 to 2011.
  2. Medicaid. 2014. Medicaid and CHIP Coverage of Lawfully Residing Children and Pregnant Women. http://medicaid.gov (accessed August 25, 2015).
  3. Brooks, T., Miskell, S., Artiga, S., Cornachione, E., & Gates, A. (2017). Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2017: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://files.kff.org (accessed February 3, 2017).
  4. Ringwalt, S. (Comp.). (2015). Summary table of states' and territories' definitions of/criteria for IDEA Part C eligibility. http://www.nectac.org (accessed August 25, 2015).
  5. Kaiser Commission on Medicaid and the Uninsured. (2017). Status of State Action on the Medicaid Expansion Decision. http://kff.org (accessed February 2, 2017).
  6. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2016). The Annual EPSDT Report (Form CMS-416) for FY 2015. https://www.medicaid.gov (accessed December 12, 2016).
  7. National Newborn Screening and Genetics Resource Center. (2014). National Newborn Screening Status Report. http://genes-r-us.uthscsa.edu (accessed March 24, 2015).