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Louisiana Medicaid Eligibility Manual Eligibility Determinations

Issued August 11, 2023

Page 1 of H-3030 Replacing March 3, 2021 Revised/added text indicated by underscore

Deleted text indicated by “**” H-3030 CHILDREN UNDER AGE 19 GROUP-LaCHIP

H-3031 GENERAL INFORMATION

The Balanced Budget Act of 1997, enacted on August 5, 1997, established a children's health insurance program under Title XXI of the Social Security Act. The purpose of this program is to enable States to initiate and expand the provision of child health assistance to uninsured, low-income children.

The law allows Louisiana to expand coverage to "targeted low-income children" under an expansion of Medicaid (for children who would not qualify for Medicaid under State rules in effect as of April 15, 1997), a separate state child health insurance program, or through a combination of these programs.

Senate Bill No. 78 of the First Extraordinary Session of the 1998 Louisiana Legislature authorized implementation of the State Children's Health Insurance Program (LaCHIP) as a combination of an expanded Medicaid program and a separate child health insurance program and placed administrative authority with the Department of Health and Hospitals. Initial implementation involved only an expansion of Medicaid.

A "targeted low-income child" is one:

• Who is under age 19;

• Whose MAGI-based income meets the specified cut-off level;

• Who does not have other insurance; and

• Who has been determined eligible for child health assistance under the state plan.

By opting to expand health insurance coverage to targeted low-income children through a Medicaid expansion, a State may cover the same groups of children which they would be permitted to cover under a separate state child health insurance program. For Medicaid purposes, these children are referred to as "optional targeted low- income children".

The Patient Protection and Affordable Care Act of 2010, referred to as the Affordable Care Act (ACA), combines all mandatory and optional