1115 Waiver Amendments – Five States Expand Medicaid Continuous Eligibility

What is continuous eligibility? Why is it important for children?

Continuous eligibility allows people enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) to have uninterrupted access to care. Regardless of changes, like increased income, individuals can keep their health insurance. This is critical for children to get the care they need when they need it, without their parents worrying how changes in their work schedule might affect their child’s coverage.  

Research shows that Medicaid eligibility improves health into adulthood. It also improves educational outcomes and contributes to higher rates of employment and earnings as adults.  

Updates

In November, the Biden-Harris administration approved five (5) section 1115 demonstration amendments to help more Americans get and keep health care coverage. These amendments expand continuous eligibility across these 5 states for children and people leaving incarceration. 

• Colorado:  

• • Medicaid and CHIP continuous eligibility until the third birthday 

• • 12 months continuous eligibility for individuals aged 19-64 leaving incarceration 

• Hawaii: 

• • Continuous eligibility until the sixth birthday 

• • 24 months of continuous eligibility for children aged 6-19 

• Minnesota: 

• • Continuous eligibility until the sixth birthday. 

• • 12 months of continuous eligibility for children 19-21 

• New York: 

• • Medicaid and CHIP continuous eligibility until the sixth birthday 

• Pennsylvania: 

• • Continuous eligibility until the sixth birthday 

• • 12 months continuous eligibility for high-risk individuals aged 19-64 leaving incarceration