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8 Effective July 1, 2014, SB 857 (Chapter 31, Statutes of 2014) eliminated the MRMIB and transferred its responsibilities to the Department of Health Care Services (DHCS). This bill required the elimination of the HFP under California’s separate program and the transition of the majority of children in the HFP to a title XXI funded Medicaid expansion program. The bill also prohibited DHCS from approving additional local entities for participation in CCHIP. In addition, SB 857 required local entities that were participating in CCHIP on March 23, 2010, to continue to participate in the program, maintaining eligibility standards, methodologies, and procedures at least as favorable as those in effect on March 23, 2010, through September 30, 2019 (September 30, 2019 the federal Maintenance of Effort (MOE) date). If a county participating in the program as of March 23, 2010, elects to cease funding the non-federal share of program expenditures during the MOE timeframe, the bill requires DHCS to provide funding from the General Fund in amounts equal to the total non-federal share of incurred expenditures.

On December 31, 2012, California received approval from CMS to amend California's section 1115 demonstration, the "California Bridge to Reform Demonstration (11-W-00193/9)." The authority provided California with time limited authority to transition a population of approximately 751,293 children from HFP into a Medicaid (Medi-Cal) expansion demonstration population in several phases. Approval of this demonstration amendment was effective through December 31, 2013. The state also received approval on April 29, 2015 to expand coverage to optional targeted low-income children with family incomes up to and including 250 percent of the FPL under the Medicaid state plan (SPA CA-13-0021).

As specified above, the programs covered under CHIP transitioned from the authority of MRMIB to the DHCS. As part of this transition, the majority of children covered under HFP were transitioned to a new Medicaid expansion program, referred to in California as the Optional Targeted Low-Income Children’s Program (OTLICP). However, the state continues to cover four populations, described in detail below, in its separate CHIP. • CCHIP children in three counties (Santa Clara, San Francisco, and San Mateo): This program retains its name and program operations. • Unborn children (pregnant women): Lower income  Benefits and cost sharing for the lower income children are based on the Medi-Cal program. This program is referred to as the “unborn option.” • Unborn children (pregnant women): Upper income  Benefits and cost sharing for the upper income children are based on state employee benchmark coverage. This program is referred to as the Medi-Cal Access Program (MCAP), and was formerly referred to as AIM. • Infants. This program was originally referred to as MCAP infant program, and is now referred to as the Medi-Cal Access Infant Program (MCAIP).

Overview of Current Structure of Coverage in California and CHIP Combination Program