Understanding Medicaid and CHIP: A Comprehensive Overview

Comprehensive Overview

What are Medicaid and CHIP? Medicaid is a means-tested program jointly financed by states and the federal government, which provides healthcare
coverage for millions of Americans, with over 72 million enrollees in 2024.1 The federal government provides the majority of Medicaid’s funding and sets parameters that all states must meet, while the states administer their own Medicaid program.2 The Children’s Health Insurance Program
(CHIP) is a joint federal and state program that supplements Medicaid by matching state funds for the health care coverage of children, inclusive of ages 0-18, whose families cannot afford private health insurance coverage but earn too much money to qualify for Medicaid.2 In 2024, over 7 million children were enrolled in CHIP.1 Combined, Medicaid and CHIP cover nearly 80 million people, of which almost 38 million are children.1 Who is Covered? Medicaid Although eligibility rules differ between states, Medicaid is federally required to cover low-income families, individuals who receive Supplemental Security Income, and qualified pregnant women and children, amongst others.3 Families are considered low-income if their household income is below the federal poverty level (FPL) for their household size. Some people who meet Medicaid requirements may also qualify for dual coverage under Medicaid and Medicare,
which covers individuals aged 65 years or older or individuals with qualifying disabilities.

CHIP
Eligibility rules for CHIP also differ on a stateby-state basis, but at a minimum, children qualify for CHIP if their family income is between the Medicaid income threshold and up to 50 percent above the Medicaid income threshold. In most states, for a family of four, children of households with incomes below
$60,000 may qualify for CHIP. In other states, children can qualify for CHIP under a greater household income threshold.4

To read more:  ANAPOL_Medicaid 101_FINAL