New Jersey Medicaid, SCHIP, & Federal Authority

Section 1115 Waiver – In 2001, the state received approval  from the Centers for Medicare and Medicaid Services (CMS) to implement a waiver demonstration that extended coverage to parents of Medicaid or State Children’s Health Insurance Program (SCHIP)-eligible children with incomes up to 200 percent of the federal poverty level (FPL) and pregnant women with incomes between 185 percent and 200 percent of the FPL. Under this waiver program, Medicaid covered parents with incomes up to 133 percent of the FPL, and SCHIP covered parents with incomes between 134 percent and 200 percent of the FPL. Although parent enrollment was capped as of June 14, 2002, parent enrollment up to 100 percent of the FPL was initiated again on September 1, 2005. This increased to 115 percent of the FPL on September 1, 2006, increased again to 133 percent of the FPL on September 1, 2007, and increased further to 200 percent of the FPL for 2008.

Health Insurance Flexibility and Accountability (HIFA) Demonstration Waiver - In 2003, New Jersey received approval from CMS to modify the SCHIP 1115 waiver. The waiver modification standardized coverage to uninsured parents and relative caretakers of children in the Medicaid and SCHIP programs whose incomes are at or below 133 percent of the FPL to that of the parents between 134 percent and 200 percent of the FPL, which was a standard commercial benefit package.

On July 8, 2008 Governor Corzine signed a health reform bill that will be effective one year after enactment.  This legislation includes a mandate that all children 18 years and younger must have health coverage.  It also increases the eligibility level for parents in the New Jersey Family Care program to 200 percent of FPL.