Cost Sharing for Children and Families
Where States Stand
Due to the federal standards largely precluding it and states’ sensitivity to the negative impact of cost sharing, most parents and children in public programs with income below 150 percent of the federal poverty level are not subject to significant cost sharing. The only states imposing premiums on children below 150 percent of the federal poverty level are Alabama, Arizona, California, Delaware, Florida, Georgia, Idaho, Nevada, Tennessee, and Utah, and they can do so only because they operate separate SCHIP programs (or have received federal waivers to do so for their Medicaid population). The use of cost sharing varies far more across states when it comes to children with family income above 150 percent of the federal poverty level. According to a January 2008 survey of Medicaid and SCHIP programs, 26 states charge premiums at 151 percent of the federal poverty level and 29 states charge premiums at 200 percent of the federal poverty level.1
Low-income families also sometimes pay a cost when using services, usually in the form of copayments. As of January 2008, 18 states require copayments for a non-preventive physician visit for a child with family income at or above 200 percent of the federal poverty level (ranging from $5 to $20), and 21 states require prescription drug copayments for children at this income level.2
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Research
Footnotes
1. D. Cohen Ross, A. Horn & C. Marks, "Health Coverage for Children and Families in Medicaid and SCHIP: State Efforts Face New Hurdles," Kaiser Commission on Medicaid and the Uninsured, (January 2008).
2. Ibid.
