Medicaid, SCHIP, and Federal Authority²

HIFA waiver - In 2002, Illinois received approval from CMS for a HIFA waiver . The waiver allowed the State to provide FamilyCare coverage to parents and caregiver relatives of children eligible for SCHIP up to 185 percent of FPL. FamilyCare was fully phased-in over the course of several years, with the final expansion to 185 percent FPL taking effect January 1, 2006.

Illinois also operates a premium assistance program - All Kids/FamilyCare Rebate - under its HIFA waiver, which allows eligible children between 134 and 200 percent FPL, and parents or caregiver relatives between 134 and 185 percent FPL to enroll in employer-sponsored or private insurance and receive a monthly rebate from the State. The program pays up to $75 per month for each family member enrolled in private health insurance and families can switch back to All Kids or FamilyCare direct coverage at any time.

Federal Financial Participation ("FFP") under Illinois ' rebate program depends on the insurance status of a child or adult when a Rebate application is filed. Illinois receives reimbursement from Title XIX for insured applicants and reimbursement from Title XXI for uninsured applicants. Additionally, Illinois must offer to pay for immunizations for insured children who are approved for Rebate.

All-Kids - In October 2005, Illinois renamed its children's coverage program - the program known as KidCare became All Kids. Effective July 1, 2006, All Kids coverage expanded to children who need health insurance, regardless of family income or immigration status. Cost-sharing in the form of monthly premiums and co-pays is determined by family income. Illinois continues to draw federal matching funds for children under 200 percent of FPL who meet immigration requirements. The State pays for higher income children and children who do not meet immigration requirements with State-only funds.

High-Risk Pool  

Illinois ' high risk pool, the Illinois Comprehensive Health Insurance Plan (ICHIP), became operational in 1989. Total enrollment in ICHIP was approximately 16,550 as of January, 2007. In 2006, premiums were set between 125 and 150 percent of the average charged for comparable coverage. ICHIP operates two programs:

• The traditional CHIP covers the medically uninsurable and is funded by premiums paid by participants and state general funds. Enrollment in traditional ICHIP was approximately 5,800 in January of 2007.
• HIPAA-CHIP covers Health Insurance Portability and Accountability Act (HIPAA) and Health Coverage Tax Credit (HCTC) qualified individuals and is funded through member premiums and an assessment on the insurance industry. From 2004 through 2006, federal grant funds helped offset premium. Premiums are set at 135 percent of the average charges for comparable services. At the beginning of January 2007, approximately 10,750 persons were enrolled in this portion of ICHIP.

Other

Three-Share - Illinois has several "three-share" models, designed by local community groups, that combine contributions from the employer, the employee, and some community subsidy to create a lower-cost product traditionally aimed at small business.  Illinois had an active program in Winnebago ( Rockford ) County.  The program suspended operation in October 2006 until a more stable community subsidy could be developed.  Other programs in Macoupin and Sangamon counties will be able to begin enrollment once a stable community subsidy is in place.

Funded by a Health Resources and Services Administration (HRSA) State Planning Grant pilot grant, the Illinois Division of Insurance assisted with the development of two pilot community "three-share" programs for St. Clair County and a program for Jackson , Franklin and Williamson Counties . The product is designed for low-wage, small businesses (2-50 employees) that currently do not offer insurance.  These programs will begin enrollment once a stable community subsidy is in place.

	Notes and Sources

Information presented in the profile was summarized in December 2006 from a review of state Web sites and reports, and through contacts with state officials. In most cases the profiles were reviewed by state officials; however, it is possible that states have implemented strategies that are not reflected in this profile.

² The profile only includes Medicaid and SCHIP waivers intended to make comprehensive expansions to the uninsured. At this time, the profiles do not include Family Planning, Pharmacy Plus waivers, or long-term care waivers.

³ Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2005 and 2006 Current Population Survey.