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State Choices to Promote Access

Young children under age 6 who
lack health insurance, 2015

Source1

Percent of eligible children who received at
least one EPSDT* screening, by age, FY 2015

Source2

[]3

  • Children <1 year
    Set eligibility at 217% (M-CHIP)
  • Children 1-5 years
    Set eligibility at 217% (M-CHIP)
  • Children 6-18 years
    Set eligibility at 217% (M-CHIP)
  • Pregnant women
    Set eligibility at 200% (Medicaid and Unborn Child Option: CHIP-funded)
  • [2014]4
  • [2014]4
  • Provides temporary coverage to pregnant women under Medicaid until eligibility can be formally determined [2017]5
  • Provides temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined [2017]5
  • Includes at-risk children in the definition of eligibility for IDEA Part C [2014]6
  • Does not require redetermination of eligibility for Medicaid/CHIP more than once a year [2017]5
  • Has adopted Medicaid expansion as part of the Affordable Care Act [2017]7

State Choices to Promote Quality

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2015]2

  • 7 Screenings for children <1 year
    State requires 7 screens. 98% of eligible screens were completed in 2015.
  • 4 Screenings for children 1-2 years
    State requires 4 screens. 100% of eligible screens were completed in 2015.
  • 3 Screenings for children 3-5 years
    State requires 4 screens. 60% of eligible screens were completed in 2015.
  • 4 Screenings for children 6-9 years
    State requires 4 screens. 51% of eligible screens were completed in 2015.
  • Requires newborn screening for the 31 metabolic deficiencies/disorders and core conditions [2014]8
  

Data Notes and Sources

Last Updated: October 29, 2015

Send us recent developments to update your state's profile.

  1. National data were calculated from the 2011 American Community Survey, representing information from 2011. State data were calculated from the 2009-2011 American Community Survey, representing information from the years 2009 to 2011.
  2. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services. (2016). The Annual EPSDT Report (Form CMS-416) for FY 2015. https://www.medicaid.gov (accessed December 12, 2016).
  3. Medicaid. 2014. Medicaid and CHIP Coverage of Lawfully Residing Children and Pregnant Women. http://medicaid.gov (accessed August 25, 2015).
  4. Brooks, T., Miskell, S., Artiga, S., Cornachione, E., & Gates, A. (2017). Medicaid and CHIP Eligibility, Enrollment, Renewal, and Cost-Sharing Policies as of January 2017: Findings from a 50-State Survey. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://files.kff.org (accessed February 3, 2017).
  5. Ringwalt, S. (Comp.). (2015). Summary table of states' and territories' definitions of/criteria for IDEA Part C eligibility. http://www.nectac.org (accessed August 25, 2015).
  6. Kaiser Commission on Medicaid and the Uninsured. (2017). Status of State Action on the Medicaid Expansion Decision. http://kff.org (accessed February 2, 2017).
  7. National Newborn Screening and Genetics Resource Center. (2014). National Newborn Screening Status Report. http://genes-r-us.uthscsa.edu (accessed March 24, 2015).