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By Ryan Kennelly

April 26, 2021

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  • Individual & Family Health Insurance
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A Guide to CHIP (Children’s Health Insurance Program)

April 26, 2021

  • Individual & Family Health Insurance

What is CHIP?

The Children’s Health Insurance Program (CHIP) is a joint federal and state program that provides health coverage to uninsured children in families with incomes too high to qualify for Medicaid, but too low to afford private coverage. The upper eligibility levels in separate CHIPs range from as low as 170 percent of the Federal poverty level (FPL) up to 400 percent of the FPL, and vary by state. CHIP and

CHIP was originally passed into law under the Balanced Budget Act of 1997, and most recently extended through federal fiscal year 2027 under the Helping Ensure Access for Little Ones, Toddlers, and Hopeful Youth by Keeping Insurance Delivery Stable Act (HEALTHY KIDS Act) and the Advancing Chronic Care, Extenders and Social Services Act (ACCESS Act).

Eligible Populations

Federal law provides states with the option to cover targeted low-income children and targeted low-income pregnant women under a separate CHIP. In addition, states can provide coverage to certain groups that were historically excluded from CHIP, such as children or pregnant women that are lawfully residing, or have access to public employee coverage. Descriptions of these options are provided below.

Targeted Low-Income Children

In order to be eligible for CHIP, a child must be:

  • Under 19 years of age,
  • Uninsured (determined ineligible for Medicaid, and not covered through a group health plan or creditable health insurance),
  • A citizen or meet immigration requirements,
  • A resident of the state, and
  • Eligible within the state’s CHIP income range, based on family income, and any other state specified rules in the CHIP state plan.

The following children cannot be eligible for CHIP:

  • Inmates of a public institution,
  • Patients in an institution for mental diseases, and
  • Children who are eligible for health benefits coverage under a State health benefits plan due to a family member’s employment with a public agency (unless a state qualifies for either the maintenance of agency contribution, or hardship exception described below).

The following table provides eligibility levels in each state for key coverage groups that use Modified Adjusted Gross Income (MAGI), as of October 1, 2020.

StateChildren Medicaid Ages 0-1Children Medicaid Ages 1-5Children Medicaid Ages 6-18Children Separate CHIPPregnant Women MedicaidPregnant Women CHIP
Alabama141%141%141%312%141%N/A
Alaska203%203%203%N/A200%N/A
Arizona147%141%133%200%156%N/A
Arkansas142%142%142%211%209%N/A
California261%261%261%See note6208%N/A
Colorado142%142%142%260%195%260%
Connecticut196%196%196%318%258%N/A
Delaware212%142%133%212% (1 up to 19)212%N/A
District of Columbia319%319%319%N/A319%N/A
Florida206%140%133%210% (1 up to 19)191%N/A
Georgia205%149%133%247%220%N/A
Hawaii5308%308%308%N/A191%N/A
Idaho142%142%133%185%133%N/A
Illinois142%142%142%313%208%N/A
Indiana208%158%158%250%208%N/A
Iowa375%167%167%302% (1 up to 19)375%N/A
Kansas166%149%133%227%166%N/A
Kentucky195%159%159%213%195%N/A
Louisiana212%212%212%250%133%N/A
Maine191%157%157%208%209%N/A
Maryland317%317%317%N/A259%N/A
Massachusetts200%150%150%300%200%N/A
Michigan212%212%212%N/A195%N/A
Minnesota283%275%275%N/A278%N/A
Mississippi194%143%133%209%194%N/A
Missouri196%150%150%300%196%300%
Montana143%143%143%261%157%N/A
Nebraska213%213%213%N/A194%N/A
Nevada160%160%133%200%160%N/A
New Hampshire318%318%318%N/A196%N/A
New Jersey194%142%142%350%194%200%
New Mexico300%300%240%N/A250%N/A
New York218%149%149%400%218%N/A
North Carolina210%210%133%211% (6 up to 19)196%N/A
North Dakota170%170%170%NA%157%N/A
Ohio206%206%206%N/A200%N/A
Oklahoma205%205%205%N/A133%N/A
Oregon185%133%133%300%185%N/A
Pennsylvania215%157%133%314%215%N/A
Rhode Island261%261%261%N/A190%253%
South Carolina208%208%208%N/A194%N/A
South Dakota182%182%182%204%133%N/A
Tennessee195%142%133%250%195%N/A
Texas198%144%133%201%198%N/A
Utah139%139%133%200%139%N/A
Vermont312%312%312%N/A208%N/A
Virginia143%143%143%200%143%200%
Washington210%210%210%312%193%N/A
West Virginia158%141%133%300%185%300%
Wisconsin301%186%151%301% (1 up to19)301%N/A
Wyoming154%154%133%200%154%N/A

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