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

Effective Date: August 24, 2001

Approval Date: 6 Beginning July 1, 1998 eligibility levels for Medicaid and M-SCHIP were increased to include children ages 6 through 18 in families with incomes above 100% but not exceeding 133% of the FPL. Beginning April 1, 1999 the income eligibility levels for Medicaid and M-SCHIP increased from 133% to 140% of the FPL for children from birth through age 18. Beginning July 1, 2000, eligibility levels for SCHIP were increased and included children birth through age 18 from 141% to 200% of the FPL, with implementation of CHIP-NM.

Children from families with incomes in the expanded levels, who were uninsured and not otherwise eligible for Medicaid, received SCHIP coverage. All others who were eligible received Medicaid. The chart shows that the number of children with qualified coverage from Medicaid or SCHIP increased by 21,918 during the time period of SCHIP operation.

During this time period, 83% of the Medicaid enrolled children had no other health coverage when enrolled in the Medicaid program. All SCHIP enrolled children were, by definition, uninsured. Using this information the following table shows the number of uninsured children who received qualified coverage since SCHIP implementation.

Medicaid-SCHIP Enrollment of Uninsured Children Baseline Year Reporting Period Uninsured Medicaid SCHIP Total 1999 06/30/1998-09/30/1998 1,188 903 2,091 2000 10/01/1998-09/30/1999 2,381 1,585 3,966

2000 10/01/1999-09/30/2000 2,265 2,192 4,457 2001 10/01/2000-09/30/2001 3,960 2,490 6,450 2002 10/01/2001-03/31/2002 1,782 801 2,583 Totals

11,576 7,971 19,547 Source: MR63

The Census Bureau Current Population Survey reported 13,000 uninsured children under 200% of the FPL for South Dakota based upon its three year averages from 1996,1997 and 1998. South Dakota believes the CPS estimate was the best source of baseline data available for the number of uninsured children when SCHIP was implemented. The data in the preceding table indicates the actual enrollees into the Medicaid or SCHIP programs that were uninsured prior to enrollment. In 2001, South Dakota was one of nine states awarded a one-year Health Resources and Services Administration grant to develop a plan for expanding access to affordable health coverage to all state residents. The State contracted with The Lewin Group to collect and analyze information about the uninsured and underinsured in South Dakota. The Lewin Group concluded that South Dakota’s uninsured population for children under the age of 19 is considerably less than the CPS estimates. The Lewin Group estimates