Compendium of Budget Information for the 2012 General Session
| Social Services Appropriations Subcommittee | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
| Subcommittee Table of Contents | |||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Line Item: Children's Health Insurance Program Function The Children's Health Insurance Program (CHIP) provides health insurance coverage to uninsured children up to age 19 living in families whose income is less than 200 percent of the Federal Poverty Level (FPL). Additionally, eligible children must: (1) not be currently covered by health insurance, (2) not have voluntarily terminated private health insurance within the last 90 days, and (3) be U.S. citizens or legal residents. There is no asset test for CHIP eligibility. For more information please visit http://health.utah.gov/chip/howtoapply.htm. In November 2006, Utah's Premium Partnership for Health Insurance (UPP) was created to enable families to receive a partial reimbursement of their health insurance premium using CHIP funds if enrolled in their employer's health care coverage or in COBRA continuation coverage. Children on UPP are funded through this line item. UPP pays monthly up to $120 per child to pay the premiums of qualifying employee-sponsored health insurance and up to $20 monthly for qualifying employee-sponsored dental insurance. Children that do not have access to affordable employee-sponsored dental insurance may enroll in CHIP dental coverage. Children who qualify can live in families that make up to 200% of the Federal Poverty Level. Adults on UPP are funded through the Medical Optional Services line item. The major portion of the funding for CHIP comes from federal funds. The authorized level of federal funds is tied to the State's Medicaid rate, but at an enriched level. Because the State of Utah has a relatively high Medicaid rate, the CHIP services match rate is also fairly high as compared to the national average. CHIP clients receive services from one of two managed care plans operating under fully risk-based, capitated contracts. The benefit package for CHIP emphasizes prevention and is based on the benefit package offered by the health maintenance organization in the State with the largest commercial enrollment. Well-child exams and immunizations are covered at 100 percent with no cost to clients. Some services require cost sharing, which varies depending on a family's income level. Cost sharing by clients is actuarially equivalent to the cost sharing in private health plans for families with incomes from 151 to 200 percent FPL, but may not exceed 5 percent of the household's gross income in any given year. The federal government places additional limits on cost sharing for the lowest income families (Plans A & B) with incomes less than 151 percent FPL. Statutory Authority The Children's Health Insurance Program is governed by the Utah Health Code in Title 26 of the Utah Code.
Intent Language Under Section 63J-1-603 of the Utah Code the Legislature intends that appropriations provided for the Children's Health Insurance Program in Item 104 of Chapter 2 Laws of Utah 2010 not lapse at the close of Fiscal Year 2011. The use of any nonlapsing funds is limited to caseload and utilization increases. Funding Detail For analysis of current budget requests and discussion of issues related to this budget click here.
|