The majority of these children live in families that earn too much to qualify for Medicaid, but not enough to purchase to private insurance. Title XXI targets these children and will help them obtain health insurance. Supporting State Programs HHS has been working closely with States to help promote understanding of the new law. HHS has published guidance on CHIP to help States create their Title XXI plans. Background The Children's Health Insurance Program is a voluntary program carried out by the States.
States have a high level of flexibility to design their programs.
Generally, uninsured children in families at or below 200 percent of the poverty level who are not eligible for Medicaid are eligible for participation in CHIP at State option. States receive reimbursement for expenditures under Title XXI from the Federal government based on an enhanced Medicaid matching rate, which is determined by a set formula. No State enhanced matching rate may exceed 85 percent. Each State is able to receive a capped allotment from the total amount of money available. From 1998 to 2000, the national allotment is divided among States based on a Census Bureau count of the number of uninsured children in a State at or below 200 percent of the poverty level, with an adjustment for regional differences in health care costs.