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Official source

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

Prior Approval Date: - 6G - Table 1: Missouri Children (age 18 and under) with Creditable Coverage Poverty Threshold Total White alone Black/ African Amer alone Amer Indian/ Alaska Native alone Asian alone Native Hawaiian/ Other PI alone Two or more races All Income Levels Totals 1,351,245 1,100,440 192,921 4,363 11,498 337 41,687 Male 674,513 547,606 94,633 2,720 7,598 337 21,620 Female 676,732 552,834 98,288 1,643 3,900 0 20,067 Below 100% Totals 212,552 130,472 73,620 817 1,427 0 6,215 Male 99,589 60,112 35,107 817 435 0 3,118 Female 112,963 70,361 38,512 0 992 0 3,098 100% to below 200% Totals 248,364 193,166 44,731 1,710 2,533 337 5,887 Male 127,146 102,184 20,701 1,454 1,062 337 1,407 Female 121,218 90,982 24,030 256 1,471 0 4,479 200% to below 300% Totals 270,927 216,026 40,696 301 1,576 0 12,328 Male 139,112 110,950 18,243 0 1,120 0 8,798 Female 131,815 105,076 22,453 301 455 0 3,530 300% to below 400% Totals 234,519 200,738 24,154 428 946 0 8,252 Male 112,685 93,515 14,991 0 542 0 3,637 Female 121,834 107,223 9,163 428 404 0 4,616 400% to below 500% Totals 152,132 141,519 4,707 659 3,182 0 2,065 Male 82,148 75,632 3,088 0 2,605 0 822 Female 69,984 65,888 1,618 659 577 0 1,242 500% and above Totals 232,751 218,517 5,012 449 1,833 0 6,940 Male 113,834 105,213 2,501 449 1,833 0 3,838 Female 118,918 113,305 2,511 0 0 0 3,102 Source: U.S. Census Bureau Current Population Survey, Annual Social and Economic Supplement, 2004 through 2006.

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Page 15

Official source

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

Prior Approval Date: - 6G - Table 1: Missouri Children (age 18 and under) with Creditable Coverage Poverty Threshold Total White alone Black/ African Amer alone Amer Indian/ Alaska Native alone Asian alone Native Hawaiian/ Other PI alone Two or more races All Income Levels Totals 1,351,245 1,100,440 192,921 4,363 11,498 337 41,687 Male 674,513 547,606 94,633 2,720 7,598 337 21,620 Female 676,732 552,834 98,288 1,643 3,900 0 20,067 Below 100% Totals 212,552 130,472 73,620 817 1,427 0 6,215 Male 99,589 60,112 35,107 817 435 0 3,118 Female 112,963 70,361 38,512 0 992 0 3,098 100% to below 200% Totals 248,364 193,166 44,731 1,710 2,533 337 5,887 Male 127,146 102,184 20,701 1,454 1,062 337 1,407 Female 121,218 90,982 24,030 256 1,471 0 4,479 200% to below 300% Totals 270,927 216,026 40,696 301 1,576 0 12,328 Male 139,112 110,950 18,243 0 1,120 0 8,798 Female 131,815 105,076 22,453 301 455 0 3,530 300% to below 400% Totals 234,519 200,738 24,154 428 946 0 8,252 Male 112,685 93,515 14,991 0 542 0 3,637 Female 121,834 107,223 9,163 428 404 0 4,616 400% to below 500% Totals 152,132 141,519 4,707 659 3,182 0 2,065 Male 82,148 75,632 3,088 0 2,605 0 822 Female 69,984 65,888 1,618 659 577 0 1,242 500% and above Totals 232,751 218,517 5,012 449 1,833 0 6,940 Male 113,834 105,213 2,501 449 1,833 0 3,838 Female 118,918 113,305 2,511 0 0 0 3,102 Source: U.S. Census Bureau Current Population Survey, Annual Social and Economic Supplement, 2004 through 2006.