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19 Effective Date: July 1, 2009

Approval Date: 2.2.1. The steps the state is currently taking to identify and enroll all uncovered children who are eligible to participate in public health insurance programs (i.e., Medicaid and state-only child health insurance): Washington operates several programs to provide healthcare coverage to low- income children. The largest of these programs is Medicaid, which provides coverage to over 680,000 U.S. citizen and legal alien children annually, in households with incomes up to 200% FPL2 To facilitate the success of these programs, Washington has engaged in a number of enrollment and retention strategies to ensure a high penetration rate into Medicaid and CHIP eligible populations. Among our best practices are:

. Since 1988, Washington has operated the Basic Health Program (BHP) providing premium-subsidized health insurance to approximately 60,000 low- income adults and families (including children) with incomes up to 200% FPL. Washington’s CHIP program began in 2001 and currently provides coverage to nearly 20,000 children in households with incomes between 200% - 300% FPL. Washington’s CHIP coverage also provides coverage for over 9,000 low-income unborn children annually whose mothers do not qualify for Medicaid, but have household income below 185% FPL. In 2006, Washington reinstated its entirely state funded Children’s Health program for low- income children who do not qualify for Medicaid or CHIP based on their citizenship status. The Children’s Health program mirrors Medicaid and CHIP in its construction. As in the CHIP program, children in households with income between 200% and 300% FPL are required to pay a premium . • Continuous Eligibility – Once a child is found eligible for medical assistance, the child remains continuously eligible for a full twelve months, regardless of changes in the household income. • No asset test - There is no resource test applied to eligibility for children’s medical programs. • No interview requirement – Families do not need a face- to- face interview. Application can be made through the mail or by electronic submission.

2 Based on 2008 Medicaid Children Title XIX SEDS report.