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

Effective Date:

Approval Date: 6 Section 2. General Background and Description of State Approach to Child Health Coverage and Coordination (Section 2102 (a)(1)-(3)) and (Section 2105)(c)(7)(A)-(B))

2.1. Describe the extent to which, and manner in which, children in the state including targeted low-income children and other classes of children, by income level and other relevant factors, such as race and ethnicity and geographic location, currently have creditable health coverage (as defined in 42 CFR 457.10). To the extent feasible, make a distinction between creditable coverage under public health insurance programs and public-private partnerships (See Section 10 for annual report requirements). (42 CFR 457.80(a))

North Carolina Health Choice for Children serves the entire state. Children who are enrolled in the program reside in all 100 counties. By age groups, fewer than 100 of these children are under age 1 at any given time because the Medicaid ceiling is 185% federal poverty level, hereinafter referred to as “fpl.” (The remainder – those falling between 185% fpl and 200% fpl equals less than one percent of the population); • ages 2 to 5 years equals 19% of the population; • ages 6 to 9 equals 29% of the population; • ages 10 to 14 equals 34% of the population; • ages 15-17 equals 15% of the population and 3 % of the children are age 18.

Children age out of the program at the end of the month in which their 19th birthday occurs.

The State of North Carolina is ethnically diverse with a growing Asian and Hispanic populations. Historically, minority populations have higher rates of uninsured children. Specific outreach efforts to ethnic and racial groups are outlined in section 5. The effectiveness of these efforts can be seen in the table, “Race NCHC 2004,” below:

The Current Population Survey, March 2005 Supplement estimated the number of children under age 19 at or below 200% of poverty to be 920,000. The number of children without health insurance was estimated at 173,000 or 7.6%.

The purpose of North Carolina’s Title XXI plan is to serve as a vehicle to encourage parents to ensure that every child in the state has access to an ongoing system of preventive health care. The program is designed to provide comprehensive health care coverage for children of working families who make too much to qualify for Title XIX and too little to afford health insurance.

Here are the basic elements of North Carolina’s Title XXI Plan: