Action Alert

January 29, 2003


Senate bills would make it easier to enroll in CHIP and Medicaid

The Issue

Three bills to improve the efficiency and coordination of the WV Children's Health Insurance Program and Medicaid have been introduced and referred to the Senate Banking and Insurance Committee. The bills would improve eligibility, enrollment and coordination of children's health insurance. The bills amend the Children's Health Insurance Program (CHIP) legislation to:

1. Coordinate coverage between the state's Medicaid services for children and CHIP to achieve a children's health care insurance program with one name, one identity and enrollment card. (Senate Bill 202)

2. Implement "presumptive eligibility," which allows primary care centers and other designated entities to provide eligible children with a temporary card or letter for health coverage until an official eligibility determination is made. (Senate Bill 203)

3. Eliminating the six month waiting period for income eligible children who have private health coverage. (Senate Bill 216)

Our Position

The WV Healthy Kids Coalition and other groups support these bills in order to assure prompt enrollment and seamless coordination of CHIP and Medicaid for our state's children.


-- In order to provide the best service for West Virginia's children, the State Medicaid program for children should look more like CHIP. It should change its image of a welfare program to become a health insurance program for the children of low income families. Other states have successfully created a health insurance program for children with one name, one identity and one enrollment card.

-- Children who are eligible for CHIP, but not enrolled in the program, sometimes come to a primary care center or other type of health facility for treatment. "Presumptive eligibility" allows the health provider to review the eligibility of the child and deem the child temporarily eligible. Final determination must still be made by DHHR but in the meantime providers will be paid for services rendered.

-- Under current rules, a child who has private insurance and is income eligible for CHIP may not enroll in CHIP until the family drops the private insurance and waits for six months. In the case where the cost of a private insurance premium is more than 10 percent of a family's income, the family may drop private coverage and become eligible for CHIP immediately. The problem with this "10 percent rule" is that it is complex and interpreted differently across the state. Dropping the 6-month waiting period would assure that eligible children are not mistakenly denied coverage.

Action needed

Contact your Senators, especially members of the Banking and Insurance Committee: Minard (Chair), Jenkins (Vice Chair), Cafin, Fanning, Helmick, Kessler, Prezioso, Sharpe, Snyder, Deem, Facemyer, Harrison, and Minear.

For more information on this issue, contact Julie Greathouse, Coordinator, WV Healthy Kids Coalition,

You can e-mail or print letters to legislators, as well as get updates on legislative issues, through the online Legislative Action Center on Children and Families at

Posted 1/29/03