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Medicaid, SCHIP, & Federal Authority

  • Section 1115 Waiver – In 2004, Mississippi received a waiver to provide Medicaid benefits to a select group of aged and disabled Mississippi residents.  There are two groups covered by this waiver 1) Aged and disabled residents with incomes below 135 percent of the federal poverty level (FPL) who do not qualify for Medicare and 2) Aged and disabled residents with incomes below 135 percent of FPL who DO qualify for Medicare and have the following conditions: patients on dialysis, patients with cancer who are receiving radiation or chemotherapy treatments, transplant patients on anti-rejection drugs and patients taking anti-psychotic medications. Coverage of the chronic conditions under the waiver ended in December 2005. Currently, about 4,400 people are served by this program in the non-Medicare waiver, and the program has a cap of 5,000. 

    Mississippi received approval from the Centers for Medicare and Medicaid Services (CMS) for a State Children’s Health Insurance Program (SCHIP) employer buy-in program, but implementation has been put on hold indefinitely. 

     

High-Risk Pools

  • The Mississippi Comprehensive Health Insurance Risk Pool Association became operational in 1992. The pool is financed by subscriber premiums and an assessment to insurers.  The premium cap is set at 150 percent of comparable coverage in the private market at initial enrollment with a maximum of 175 percent of private coverage. At the end of 2005, just over 4,300 persons were enrolled in the program.