CHIP Reauthorization became law on 4 February 2009 and it is effective 1 April 2009 to 30 September 2013. Click here to read the president's remarks. The overall goals are to continue public health insurance benefits for current recipients and cover an additional four million children and youths who are eligible but not enrolled. The question asked most often is “How will this law impact Hawaii?” Here is a summary as of 31 March 2009: Hawaii covers children and youths ages 0-19 years old up to 300% of the federal poverty level (FPL) and it will continue at this level. Hawaii uses state-only funds to provide free public health insurance for lawful permanent resident children and youths (have a “green card”) in the U.S. less than five years. There will be new funding at the CHIP federal matching rate (FMAP) for approximately 3,700 kids saving the state $2.7 million annually. Hawaii uses state-only funds to cover lawful permanent resident pregnant women in the U.S. less than five years. There will be new funding at the CHIP FMAP rate for approximately 195 monthly participants saving the state $4.4 million annually. The Department of Health and Human Services Secretary will award $80 million for outreach initiatives to states and community organizations. No state match is required. There is a maintenance of effort provision because the intent is to encourage new outreach activities not displace current state funding, therefore states must maintain existing outreach and enrollment efforts. Note: On September 30, 2009 Hawaii Covering Kids and Bay Clinic were awarded separate two-year CHIPRA outreach and enrollment grants. The state will receive an annual performance bonus for enrolling more children and youths in its regular Med-QUEST programs. This fiscal incentive is designed to encourage states to reach more low-income kids and is also based on implementing five of eight enrollment simplification measures. Additional federal funding will be provided for interpreter services. Currently, Hawaii contracts with TeleInterpreters to assist customers who do not speak English. States can verify citizenship through an electronic link with the Social Security Administration. Furthermore, eligible kids can be enrolled in public health insurance while citizenship documents are forthcoming. This will eliminate unnecessary paperwork barriers to enrolling eligible children and youths in Hawaii’s programs. Newborns in U.S. hospitals are no longer required to provide citizenship and photo identification documents. Currently, Hawaii’s hospitals send additional documents and newborn photos with a Med-QUEST application. This is a waste of resources because the babies are obviously U.S. citizens. Information from the Centers for Medicare & Medicaid Services: State Health Official Letter on 8 May 2009: Covering Pregnant Women Through CHIP (scroll down to CMS Guidance) State Health Official Letter on 17 April 2009: Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA) Overview Web sites with details about CHIP Reauthorization: Center for Children and Families: 2009 CHIP Reauthorization Families USA: Children's Health - CHIP Reauthorization National Immigration Law Center: Covering Immigrant Children Reports and information in PDF format: CHIP TIPS: Financing Structure Examines important changes to CHIP’s financing structure under the Children’s Health Insurance Program Reauthorization Act of 2009. The law includes a number of important programmatic and financing changes that affect both Medicaid and CHIP. Among the most important changes include significant new funding for the CHIP program, changes in the formula for distributing CHIP funds among states and a new option for states to decide whether to use CHIP or Medicaid funding to cover children. Taken together, the financing changes provide states with reliable federal matching funds adequate to both continue and expand their CHIP programs. Kaiser Commission on Medicaid and the Uninsured, June 2009. CHIPRA: Addressing Racial and Ethnic Health Disparities Studies four key provisions in the new law: investing in outreach, increasing access for legal immigrant children and pregnant women, increased funding for interpretation and translation services, and establishing new quality of care measures. It also includes action steps for advocates. Families USA, June 2009. More Funding for CHIP, Different Rules: How Does CHIPRA Change CHIP Funding? Summarizes the new federal financing rules for CHIP, as well as the improvements to the financing system that will help ensure that states have the funding they need to get more children covered. Families USA, June 2009. CHIP Tips: Citizenship Documentation Changes. Information about how the new law modifies current requirements to reduce the paperwork burden on families and states. Center for Children and Families, May 2009. Covering More Children, Rewarding Success: State Performance Bonuses. Discusses the new system of performance bonuses created by the Children's Health Insurance Program Reauthorization Act of 2009 (CHIPRA). Families USA, April 2009. CHIP Tips: Medicaid Performance Bonus. Explains how the Medicaid Performance Bonus works, key dates, and choices for states to implement the measure. Center for Children and Families, April 2009. CHIP Tips: Medicaid Performance Bonus "5 of 8" Requirements . To qualify for the performance bonus, states must implement at least five of eight policies in Medicaid and CHIP as described in this brief. Center for Children and Families, April 2009. CHIPRA 101: Overview of the CHIP Reauthorization. Examines major provisions including new funding, changes in eligibility, getting more children enrolled, and improving children's health. Families USA, March 2009. Setting Income Thresholds in Medicaid/SCHIP: Which Children Should Be Eligible? Important policy questions include where eligibility thresholds should be set for public health insurance and how much latitude states should have in setting their thresholds. Urban Institute, January 2009 SCHIP Children: How Long Do They Stay and Where Do They Go?. Seven-state study examining retention of children in CHIP and coverage of kids after they leave the program. Mathematica Policy Research, January 2009. Challenges of Providing Health Coverage for Children and Parents in a Recession. Kaiser Commission on Medicaid and the Uninsured, January 2009. Improving Children's Health: A Chartbook about the Roles of Medicaid and CHIP, Center on Budget and Policy Priorities, January 2007. Children's Health Insurance Eligibility Forum On 16 April 2008, Hawaii Covering Kids sponsored two national speakers, Edwin Park from the Center on Budget and Policy Priorities and Caroline Rivas from Community Health Councils, who presented information about recent federal policies and their implications for our children's health insurance programs. Topics included CHIP Reauthorization, CMS's August 17 Directive, and CMS's Payment Error Rate Measurement (PERM) program. There were also updates about the National Covering Kids & Families Network and Hawaii's progress towards covering all kids with health insurance. Click here for a PDF copy of the presentations: April 2008 Children's Health Insurance Policy Forum in Hawaii.