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Missouri Application for the State Children’s Health Insurance Program Effective Date: 09/01/2007 Approval Date: 09/28/2007

Prior Approval Date: - 6D - Table 1 Rate of Inpatient Discharges by Payer for Missouri Children under 15 in Missouri (1994-2005) - 50.0 100.0 150.0 200.0 250.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate per 10,000 Medicaid Other Gov't Commercial Self-Pay, etc. Source: DHSS MICA Data

Table 2 Rate of Inpatient Discharges by Race for Self-Pay Children under 15 in Missouri (1994-2005) - 5.0 10.0 15.0 20.0 25.0 30.0 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 Rate per 10,000 White Black All Races Source: DHSS MICA Data