As federal eligibility start date nears, fate of children’s health insurance unresolved in Pa.

    Disagreements between state and federal officials over the fate of thousands of children currently enrolled in Pennsylvania’s health insurance program, known as CHIP, have yet to be resolved barely one month before that coverage is slated to shift over to Medicaid.

    But the hard-and-fast Jan. 1 federal deadline for transferring income eligible children from CHIP to Medicaid appears to have changed.


    The Affordable Care Act requires states to open up Medicaid to kids in families earning between 100 to 133 percent of the federal poverty level as of Jan. 1, 2014 (133 percent is equivalent to an annual income of about $30,000 for a family of four). Between 40,000 and 50,000 kids in Pennsylvania now covered by the Children’s Health Insurance Program fall into that income bracket.

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    Gov. Tom Corbett has long championed CHIP and its cost effectiveness, repeatedly telling federal officials he opposes moving children out of it and into Medicaid, also known as Medical Assistance. Referring to states’ options to expand adult Medicaid eligiblity, federal officials countered moving kids into Medicaid would enable them to be on the same health plan as their parents (Governor Corbett is proposing an alternative plan Medicaid plan for adults).  

    But in a letter sent last month, federal officials told states they can ask for more time to make the transition. A Corbett representative said that request has been made as the administration continues “to look at what’s best for those Pennsylvania families that rely on PA CHIP.”

    George Hoover, with the Pennsylvania Partnerships for Children, says transferring kids has trade-offs — good and bad – but more than anything, requires educating and preparing families.

    “Medicaid provides a stronger, more robust package than [CHIP] does,” said Hoover. “However [CHIP]  generally has a larger number of providers enrolled for a family to choose from.”

    Colleen McCauley with the advocacy group Public Citizens for Children and Youth worries about the lack of information going to families who could be eligible for and stand to benefit from Medicaid come January. She hasn’t “seen the state prepare to transfer these children from CHIP to Medical Assistance.”

    Details are unclear about how, even with a delay, Pennsylvania would go about such a transfer.

    Federal officials requested a followup plan from states seeking an extension. A state spokesperson said,  via email, that Pennsylvania “continues to discuss this” with the federal Department of Health and Human Services.

    McCauley said some states may prefer to switch kids whenever it’s time to renew their CHIP plans next year, spreading out the transition over the course of several months.

    Regardless of what happens, kids in that expanded income bracket will still be eligible for Medicaid starting Jan. 1.

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