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Background • On April 1, 1998, Texas submitted its title XXI Plan (Phase I) that expanded Medicaid eligibility to children between the ages of 15 and 18 in families with incomes below 100 percent of the Federal poverty level (FPL). These children were phased into Medicaid.

• Under that original proposal, Texas provided Medicaid coverage to children up to age 1 in families with incomes up to 185 percent of the FPL, to children ages 1 to 5 in families with incomes up to 133 percent of the FPL, and to children ages 6 to 19 in families with incomes up to 100 percent of the FPL.

• Texas amended its title XXI plan (as discussed below) so that Texas currently operates a separate child health program only. The separate program provides coverage to children from birth through age 18 with incomes up to 200 percent of the FPL.

Amendments

• On June 25, 1999, Texas submitted an amendment to expand health insurance coverage to children through age 18 in families with incomes up to 200 percent of the FPL, who are not eligible for Medicaid, through a separate child health program. This amendment is referred to as Phase II.

• On June 21, 2001, Texas submitted a second amendment to acknowledge that the funding source for the State SCHIP share for State Fiscal Year 2002 and beyond will include appropriated State funds and other public funds certified or transferred from public agencies, consistent with applicable Federal laws and regulations.

• On June 21, 2001, Texas submitted a third amendment to implement an outreach pilot program that furnishes child car safety seats to families when their children re- enroll in SCHIP. The pilot program is limited to the number of families that could be served using a budget of $2,000,000. The bona-fide donations are received from the Rio Grande Valley Safe Communities Coalition and include amounts received from other approved entities. The donations are consistent with sections 1903(w) and 2107(e)(1)(C) of the Social Security Act (the Act).

• On January 24, 2002, Texas submitted a fourth amendment to change the current prescription drug benefit from a limited HMO or modified PPO formulary that is based on the TX Medicaid Program open formulary. (Note: The amendment was withdrawn by the State on August 21, 2002.)

• On February 11, 2002, Texas submitted a fifth amendment to change copayments charged to families at all income levels.

• On July l8, 2002, Texas submitted a sixth amendment to indicate the State’s

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