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State Choices to Promote Access

Young children who lack health
insurance, 2014

Source1

Percent of eligible children who received at
least one EPSDT* screening, by age, FY 2013

Source2

Income eligibility limit for public health insurance (Medicaid/CHIP) at or above 200% of the federal poverty level (FPL). [2015]3

  • Children <1 year
    Set eligibility to at least 200% (Medicaid and CHIP)
  • Children ages 1-5 years
    Set eligibility at 217% (CHIP)
  • Children ages 6-18
    Set eligibility at 217% (CHIP)
  • Pregnant women
    Set eligibility at 200% (Medicaid)
  • Medicaid and/or CHIP coverage for lawfully residing children [2014]4
  • Medicaid and/or CHIP coverage for lawfully residing pregnant women [2014]4
  • Provide temporary coverage to pregnant women under Medicaid until eligibility can be formally determined. [2015]3
  • Provide temporary coverage to children under Medicaid or CHIP until eligibility can be formally determined. [2015]3
  • Include at-risk children in the definition of eligibility for IDEA Part C. [2014]5
  • Do not require redetermination of eligibility for Medicaid/CHIP more than once a year [2013]6
  • Has adopted Medicaid expansion as part of the Affordable Care Act [2014]7

State Choices to Promote Quality

EPSDT screening periodicity schedule meets recommendations of American Academy of Pediatrics [FY 2013]2

  • 7 Screenings for children <1 year
    State requires 7 screens. 100% of eligible screens were completed in 2013.
  • 4 Screenings for children 1-2 years
    State requires 4 screens. 100% of eligible screens were completed in 2013.
  • 3 Screenings for children 3-5 years
    State requires 4 screens. 75% of eligible screens were completed in 2013.
  • 4 Screenings for children 6-9 years
    State requires 4 screens. 64% of eligible screens were completed in 2013.
  • Require 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. 2014. The Annual EPSDT Report (Form CMS-416). http://www.medicaid.gov (accessed March 24, 2015).
  3. Brooks, Tricia; Touschner, Joe; Joan; Artiga, Samantha; and Stephens, Jessica; Alexandra Gates. 2015. Modern Era Medicaid: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP as of January 2015 . Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. Http://files.kff.org (accessed August 13, 2015)
  4. Medicaid. 2014. Medicaid and CHIP Coverage of Lawfully Residing Children and Pregnant Women. http://medicaid.gov (accessed August 25, 2015).
  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. Heberlein, Martha; Brooks, Tricia; Alker, Joan; Artiga, Samantha; and Stephens, Jessica. 2012. Getting into Gear for 2014: Findings from a 50-State Survey of Eligibility, Enrollment, Renewal, and Cost-Sharing Policies in Medicaid and CHIP, 2012-2013. Kaiser Commission on Medicaid and the Uninsured, The Henry J. Kaiser Family Foundation. http://kaiserfamilyfoundation.files.wordpress.com (accessed August 13, 2013)
  7. Kaiser Commission on Medicaid and the Uninsured. 2015. Status of state action on the medicaid expansion decision . http://kff.org (accessed March 24, 2015).
  8. National Newborn Screening and Genetics Resource Center. 2014. National Newborn Screening Status Report. http://genes-r-us.uthscsa.edu (accessed March 24, 2015).