|
State |
Expansion Population |
Basic Structure |
Impact on Mental
Health Benefits |
| Arizona
Waiver Type: HIFA
Program: Arizona HIFA Amendment
Implementation:
11/1/01 (Phase 1)
10/1/02 (Phase 2)
|
· Phase
1: 27,000 Childless adults up to 100% of FPL
· Phase
2: 21,250 Parents of children in SCHIP or Medicaid,
who are between 100% and 200% of FPL |
Benefit
package is identical to 1115 acute care and SCHIP benefit
packages. |
No
change to current benefits. |
| Arkansas
Waiver Type: HIFA
Program: Arkansas Safety Net Benefit Program
Approval: Pending |
55,000
Arkansas residents of all incomes up to 200% FPL |
Employer
Sponsored Insurance (ESI): once employer elects to participate,
eligible individuals will receive SCHIP benefits package.
|
Patients
limited to 6 clinic visits, 2 outpatient hospital visits,
2 prescriptions, and 7 inpatient days per fiscal year. |
| California
Waiver Type: HIFA
Program: California Parental Coverage Expansion
Implementation: 7/1/02
|
275,000
parents, relative caretakers and legal guardians with net
incomes up to 200% of FPL not eligible for Medi-Cal |
Similar
to SCHIP and state employees’ benefit packages.
|
No
change to current benefits.
|
|
Colorado
Waiver: HIFA
Program: Adult Prenatal Coverage in CHP+
Implementation: 10/8/02
|
Uninsured pregnant women 134-185% of FPL
who are not otherwise eligible for Medicaid or SCHIP
|
Same as SCHIP benefit package
|
Mental health coverage limited to 45 inpatient
days and 20 outpatient visits per year
|
|
Delaware
Waiver Type: HIFA
Program: Delaware
Healthy Adult Program
Disapproval Issued: 3/19/03
|
Sought to use SCHIP funds to provide services
to groups already covered by Medicaid. This is not allowed
under HIFA rules.
|
Same as SCHIP
benefit package.
|
Would have provided extended 31 day mental
health benefits for adults.
|
|
Idaho
Waiver Type: HIFA
Program: Idaho Access Card
Approval: Pending
|
1,000 adults up to 185% FPL and all children
above mandatory Medicaid levels but below 185% FPL.
|
Premium assistance for employer-sponsored
insurance.
|
Dependent upon the specifics of the employer’s
insurance plan.
|
|
Illinois
Waiver Type: HIFA
Program: KidCare Parent Coverage
Implementation: 10/1/02
|
· Children
133-185% of FPL with private insurance at the time they enroll,
who receive direct coverage or premium assistance, subject
to an enrollment cap
· Parents
39-90% of FPL, who receive direct coverage or premium assistance,
subject to an enrollment cap
|
· Premium
Assistance: Monthly subsidy up to $75/person to purchase
private insurance
· Direct
Coverage: Either the states’ Medicaid or SCHIP benefit
package
|
Substance abuse care for parents limited
to 100 outpatient hours and 30 inpatient days. Nominal copays
for substance abuse/mental health visits.
|
|
Maine
Waiver Type: HIFA
Program: MaineCare for Childless Adults
Implementation: 10/1/02
|
11,500 childless adults with incomes up
to 125% FPL
|
Same benefit package as SCHIP and the Maine
Medicaid program (MaineCare)
|
No change to current benefits.
|
|
Michigan
Waiver Type: HIFA
Program: Adults Benefits Waiver program
Implementation:1/16/04
|
62,000 childless adults at or below 35%
FPL
|
The
benefit package includes inpatient, outpatient, physician’s
surgical and
medical
services, laboratory and x-ray services, pharmacy and mental
health and substance
abuse.
|
No change to current Medicaid benefits package. Mental
health and substance abuse services provided through a behavioral
managed care carve-out.
|
|
Minnesota
Waiver Type: HIFA
Program: Minnesota HIFA proposal
Application Inactive as of 7/1/02
Waiver application did not meet the Maintenance
of Effort (MOE) requirement of the HIFA demonstration program.
|
Would
have provided expanded health
insurance
coverage to an additional 115,000 residents of the State
of Minnesota with
incomes
at or below 275% of FPL.
|
N/A
|
N/A
|
|
New Jersey
Waiver Type: HIFA
Program: New Jersey Standardized Parent
Service Package
Implementation: 9/1/02
|
12,000
uninsured custodial parents and caretaker relatives of
children eligible for title XIX or
title
XXI who are not Medicaid eligible, and have family incomes
up to and including 133% of FPL.
|
The most widely
used HMO package with the largest commercial
non-Medicaid
enrollment marketed in New Jersey.
|
Hospital Services
for Mental Health
limited to 35
days per year.
Outpatient Mental
Health Services limited to 20 visits per
year, $25 co-pay.
|
|
New Mexico
Waiver Type: HIFA
Program: New Mexico State Coverage Initiative
Approval: 8/23/02
|
29,000 parents between 37 and 200% of FPL;
11,000 other adults up to 200% of FPL
|
Premium assistance for a state-established
reduced commercial benefit package. Tiered copayment system.
|
Mental health inpatient/ outpatient hospitalization
services limited to 25 days per year; substance abuse care
limited to 10-30 days per year
|
|
Oregon
Waiver Type: HIFA
Program: The Oregon Health Plan 2
Implementation: 11/1/02 through 7/1/03
|
OHP Plus: Children and pregnant women
170-185% FPL
OHP Standard: Parents and other adults
100-110% FPL
FHIAP: Children and pregnant women
170-185% FPL who choose FHIAP; Parents and other adults 100-185%
FPL
|
OHP Plus: State’s basic Medicaid
benefit package
OHP Standard: Reduced Medicaid benefit
package
FHIAP: Premium Assistance
|
OHP Plus: No change
OHP Standard: Coverage eliminated
effective March 2003
FHIAP: Mental health and chemical
dependency are covered but there is no specification about
durational limits or cost-sharing
|
