Page 66 - Book11E

MEDICAID
SCHIP
Low-income children with incomes above Medicaid eligibility levels who do not have private health insurance
“Unborn children”
Some parents and other adults through special per- mission granted by federal government
Covered Groups
Number of Children Enrolled in 2010
Low-income children
Low-income parents and pregnant women
Low-income children and adults with disabilities
Low-income elderly
34.4 million children
7.7 million children
Entitlement to states, not individuals
The annual funding level is set by statute and is based on the number of low-income children and low-income uninsured children in the state and takes into con- sideration the average pay for healthcare workers in
the state compared to the national average
Funding
Benefits Coverage
Open-ended entitlement Enrollment caps prohibited
Comprehensive range of federally defined benefits, including dental, mental health, prevention
States have flexibility in defining plans, although
all benchmark plans must include basic benefits, as defined in statute. This flex- ibility applies to separate SCHIP programs, not to Medicaid expansion programs
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Medicaid vs. SCHIP
Federal Resources for Health Care Coverage