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too high for them to qualify for Medicaid under the standard income guidelines. In Medicaid expansion plans, the same rules apply as apply to Medicaid. Medical services are through the same providers and sys- tems as Medicaid, medical benefits are the same as Medicaid, the same restrictions for the state apply, and the state may not turn away appli- cants who are eligible after a certain number of children have enrolled or after the state has exhausted its funds.
2 . State-Designed or Private Plans:
These plans allow states to create entire-
ly new programs by choosing from
several benefits package options that are
consistent with the provisions of SCHIP.
In these programs, providers, quality
standards, enrollment procedures, benefits and even the name of the program may be different from those of Medicaid. State-designed pro- grams must be approved by the secretary of the Department of Health and Human Services.
3 . Combination Plans: These plans allow states to both expand Medicaid and create a separate private plan as well, allowing for more variety in serving the needs of different populations. In state-designed plans—or state-designed portions of combination plans—SCHIP is not an entitlement. This means the program is not required to accept new enrollees if its capacity has been reached or if the state has used up all its funds. If states choose to enroll children in the program after their full SCHIP funding has been used, the states must use their own funds.
Currently, all states, territories and the District of Columbia have estab- lished SCHIP programs. Seventeen states operate a separate SCHIP program, 7 states plus the District of Columbia and 5 territories use their SCHIP funds only in Medicaid, and 26 states use a combination approach in which SCHIP funds are used to expand Medicaid and to cover a group of higher income children in a separate program.
Federal Resources for Health Care Coverage 55
Too often we give children answers to remember rather than problems to solve.
—Roger Lewin