HCFA Approves Virginia’s New CHIP Program Provisions

Virginia officials are hoping to start the Family Access to Medical Insurance Security Plan, or FAMIS, within six months, the Richmond Times-Dispatch reports. FAMIS is designed to replace the existing state Children's Medical Security Insurance Plan, or CMSIP. State officials say the change will "remove the public assistance stigma" that is "hindering" enrollment, the Times-Dispatch notes. As of Dec. 13, 29,515 out of 60,000 eligible children were enrolled in CMSIP.

Program Changes
As approved by HCFA last month, the new program "enhances benefits" and extends eligibility to children in families with annual incomes up to 200% of the federal poverty level. Families were eligible for CMSIP if their annual incomes were 185% of the poverty level or less. However, there are some eligibility changes that might disqualify families from FAMIS coverage. For example, while CMSIP's eligibility level had been lower, the program also allowed an income adjustment for certain expenses, such as child care, when determining program eligibility. FAMIS does not allow some of those adjustments.
Families who are enrolled in CMSIP will be automatically "grandfathered" into FAMIS, even if the CMSIP income deductions had been used. As a result, state advocates are pushing to enroll as many children as possible under CMSIP. "That's why enrollment in CMSIP is very important, particularly for people who have higher income but also higher child care expenses," Jill Hanken, lawyer at the Virginia Poverty Law Center, said.

A New Provision
Besides expanding the income limits, FAMIS also includes provisions that allow Virginia to pay for children to enroll in private insurance programs through their parents' employers. Under that provision, the state will cover the "child-only" part of parents' private insurance premiums. In certain instances, families will be permitted to "pay the difference to upgrade to family coverage," the Richmond Times-Dispatch reports. HFCA was concerned about the 40% employer contribution rate in the premium assistance benefit and wanted employer plans that contributed 60% or more toward the cost of family coverage to be eligible. The state, working with insurers Sentara Health Management and Trigon Blue Cross Blue Shield, was able to show that in the best of Virginia's plans, employer contributions to employee family health coverage is about 40%-50%. As a result, HCFA approved the state's plan (Smith, Richmond TimesDispatch, 1/4).