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

Effective Date:

Approval Date: 9

<100% 100-135% 135-150% 150-185% 186-200% >200% Age 5-9 uninsured 3,930 1,489 1,012 1,667 1,280 16,316 Age 10-14 Total 38,818 14,704 9,999 16,468 12,645 161,155 Age 10-14 insured 34,704 13,145 8,939 14,723 11,305 144,073 Age 10-14 Uninsured 4,115 1,559 1,060 1,746 1,340 17,082 Age 15-17 Total 23,556 8,923 6,067 9,993 7,673 97,792 Age 15-17 insured 21,059 7,977 5,424 8,934 6,860 87,426 Age 15-17 Uninsured 2,497 946 643 1,059 813 10,366 Sources: Population Research Center, Portland State University data for July 2008, Bureau of Labor Statistics/ U.S. Census; Current Population Survey (CPS)

The primary source of health coverage for most children is an employer-based policy, most often sponsored by a parent’s employer. In 1998 Employer-based coverage accounted for 82 percent of all children’s health insurance coverage in the state, while public sources made up 13 percent and the remaining 5 percent was from other sources. In 2007 Employer-based coverage decreased as the unemployment rate increased.

During Oregon’s 2009 Legislative Session, HB 2116 created the Healthy Kids initiative. Healthy Kids provides coverage for uninsured children through age 18 in the State. The objective of Healthy Kids is to provide options for children at all income levels, remove barriers to accessing health care coverage and build on existing programs already available to Oregon families. HB 2116 increases the FPL from 185 percent of FPL up to and including 300 percent of FPL for children. Healthy Kids includes three different program components: 1) Existing CHIP direct coverage under OHP Plus, 2) Child only premium assistance administered by the Office of Private Health Partnerships, and 3) A new private insurance component (Healthy KidsConnect) that will be offered under the CHIP State Plan. CHIP-eligible children that select direct coverage or Healthy KidsConnect under the CHIP state plan are governed by the title XXI state plan and subject to all title XXI laws and regulations in accordance with the title XXI State plan. Children that select FHIAP or child-only Healthy Kids ESI premium assistance under the demonstration are subject to all title XXI laws and regulations in accordance with the State plan, except as expressly waived, described as non applicable, or specified in the OHP 1115 waiver demonstration STCs. Children up to and including 200 percent of the FPL have the choice between Title XXI state plan direct coverage, or premium