Colorado Medicaid and SCHIP Waivers

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Health Insurance Flexibility and Accountability (HIFA) Waiver – In 2002, Colorado received approval from the Centers for Medicare and Medicaid Services (CMS) for a HIFA demonstration to provide adult prenatal coverage under the State Children’s Health Insurance Program (SCHIP), CHP+. The waiver, amended in 2005 to increase eligibility, provides coverage to uninsured pregnant women with incomes between 134 percent and 200 percent of the federal poverty level (FPL) who are not otherwise eligible for Medicaid and SCHIP. Additionally, this waiver provides a premium assistance option for children with family incomes at or below 200 percent of the FPL with access to employer-sponsored insurance. Beneficiaries may opt out of the premium assistance program at any time and resume coverage through SCHIP.

During the 2007 Legislative Session, Colorado passed Senate Bill 07-097, which increased CHP+ eligibility for pregnant women and children (ages 0 through 18) from 200 percent of the FPL to 205 percent, using funds from the State’s tobacco litigation settlement. This bill also approved presumptive eligibility for pregnant women throughout pregnancy and for 60 days following the pregnancy. In addition, a child born to a woman eligible for the plan is now automatically enrolled in the plan. Legislation in 2007 was also passed to extend Medicaid eligibility until age 21 for foster care children who, prior to turning age 18 or becoming emancipated, are eligible for Medicaid under Title IV-E of the Social Security Act.
In April, 2008 Governor Ritter signed legislation to expand access to SCHIP to pregnant women and children up to 225 percent of FPL. The SCHIP expansion was part of several reform proposals in Governor Ritter’s “Building Blocks to Health Care Reform” package, all of which has been approved by the 2008 state General Assembly.