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Model Application Template for the State Children’s Health Insurance Program

Effective Date:

Approval Date: 4 SCHIP Phase I, a Medicaid expansion, was approved August 6, 1998 and implemented October 1, 1998. This was a small SCHIP Medicaid expansion in which the last of the eligible children aged-out of the program September 30, 2002. SCHIP Phase II is a separate SCHIP program that was approved February 16, 2001 but not implemented. Phase III supersedes Phase II. Phase III will cover some of the children in the State’s Medicaid 1115 demonstration, ARKids B, as an SCHIP Medicaid expansion and cover unborn children as a separate child health program.

B. ARKids First Background and Development

In 1997, Arkansas’ Governor, the Arkansas State legislature, the President and Congress were all addressing the issue of health care for vast numbers of uninsured children. Governor Mike Huckabee supported enabling state legislation and an appropriations bill in the 1997 legislative session that created and funded ARKids First, a Medicaid 1115 demonstration. The Arkansas Legislature passed both bills and Governor Mike Huckabee signed both bills into law by on March 10, 1997 (see Attachments A and B). Effective August 4, 2000, the 1115 demonstration was renamed ARKids B.

Ray Hanley, then Director, Division of Medical Services (DMS), formed and chaired an ARKids First work group, which was composed of individuals from the following: the Governor’s Office (the Department of Human Services liaison), Arkansas Children’s Hospital, Arkansas Department of Health, Catholic Social Services, Arkansas Advocates for Children and Families, Easter Seals, Communities in School of Arkansas, Arkansas Chapter for American Academy of Pediatrics, Electronic Data Systems (Arkansas Medicaid’s fiscal agent), and various individuals in the Department of Human Services (DHS), including Tom Dalton, then Department Director. The first meeting was held February 7, 1997, one day after President Clinton announced his FFY98 budget package which included a proposal to expand health insurance access for poor children in families that earn too much for Medicaid but not enough to afford private health insurance. Additional ARKids First meetings were held as needed. Most of the discussion and concerns involved eligibility factors and the benefit package.

The Arkansas legislation, though not as detailed, mirrors the SCHIP legislation in its purpose, i.e., to provide health insurance coverage for uninsured children under 19 whose family income is at or below 200% of the poverty level. The ARKids First program was designed as an SCHIP program, but used the Medicaid 1115 demonstration process for