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California has historically served mothers and infants through its AIM program even if they have high deductible insurance coverage ($500 or more), because at the income of AIM mothers (200-300 percent FPL), out of pocket expenditures are so unaffordable that most mothers will be unable to use the insurance. The babies of these women may or may not have coverage once born. However, as Title XXI precludes states from serving children who have current insurance coverage, even this high deductible coverage, California will not bill the federal government under the Title XXI program to serve any infant who has access to other coverage. The AIM application asks not only whether a mother has coverage for her pregnancy, but whether that insurance will cover the infant that results from the pregnancy. A total of 1,228 of these applicants indicated that their infants had access to other insurance coverage, 4 percent of the total application pool. California will track insured status of infants enrolled in AIM and will not claim federal financial participation for children whose mothers report the availability of health coverage for the infants. Thus, MRMIB will bill for children under age one whose family income is between 200 percent and 250 percent of FPL, for those infants born to mothers enrolled in the AIM Program prior to July 1, 2004 and who are uninsured. MRMIB will also bill for children under age two whose family income is between 200 percent and 300 percent of the FPL, for those infants born to mothers enrolled in the AIM Program on or after July 1, 2004 and who are uninsured. This second group of infants that are born to mothers enrolled in the AIM Program on or after July 1, 2004 will be enrolled in the state’s Healthy Families Program. Actual claims to the federal government will be based on the data collected on infant’s insurance status from the AIM application. Section 3. Methods of Delivery and Utilization Controls (Section 2102)(a)(4)) Check here if the state elects to use funds provided under Title XXI only to provide expanded eligibility under the state’s Medicaid plan, and continue on to Section 4. 3.1. Describe the methods of delivery of the child health assistance using Title XXI funds to targeted low-income children. Include a description of the choice of financing and the methods for assuring delivery of the insurance products and delivery of health care services covered by such products to the enrollees, including any variations. (Section 2102)(a)(4) (42CFR 457.490(a)) Effective Date: Approval Date: November 1, 2009 HFP Family Contribution Increase November 1, 2009 HFP Co-Payment Increase November 1, 2009 HFP Limited Dental Plan Choice for New Subscribers

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